symptoms

I am watching the computer curser taunt my inability to collect my thoughts. Three days out of chemotherapy, my brain is more fried than usual, the fog thick and dense. For those unfamiliar with cog fog (cognitive fog), it is a clouding…

It seemed to be such a harmless rabbit hole. After last week’s column on Rolfing — and a response divided between those who thought it sounded like terrible torture and those who agreed it was torture but they liked it — I decided to explore some other ideas…

Multiple sclerosis patients have high levels of a protein called osteopontin in their cerebrospinal fluid and blood, making it a potential tool for diagnosing the disease and predicting its course, a study suggests. The research, “Osteopontin (OPN) as a CSF and blood biomarker for multiple sclerosis: A systematic review and meta-analysis,” was published in the journal PLOS One. Researchers wanted to know if levels of osteopontin in cerebrospinal fluid and blood could be a reliable biomarker for MS. To arrive at answer, they “conducted a systematic review and meta-analysis" of studies that had measured the protein's levels in cerebrospinal fluid and blood "in MS patients and controls." The team searched for studies in three databases — PubMed, Web of Science and Scopus. Out of 27 that met their criteria, they used 22 in the meta-analysis. All four types of MS were represented in the studies — clinically isolated syndrome, relapsing-remitting MS, secondary progressive MS, and primary progressive MS. There were three types of controls in the articles — healthy people, people with non-inflammatory neurological disorders, and people with inflammatory neurological disorders. Researchers' first observation was that all of the MS patients had higher levels of osteopontin than controls. The protein's levels were significantly higher in relapsing-remitting MS patients than in those with clinically isolated syndrome, the group with the lowest osteopontin levels. Levels were similar in the other types of MS. Patients with an active disease had significantly higher levels of the protein in their cerebrospinal fluid than those with a stable disease. The results supported previous studies' findings that osteopontin levels are higher than normal in the cerebrospinal fluid and blood of MS patients, strengthening the notion that it could be used as a biomarker for MS. “Given the fact that OPN [osteopontin] levels are higher during relapses, we think that by monitoring this biomarker,  we might be able to predict the disease course," the team wrote. "We propose that developing drugs modulating OPN concentration may be a new treatment strategy for MS."

Multiple sclerosis patients with central nervous system pain have high levels of a protein known as nerve growth factor in their cerebrospinal fluid, a study shows. The research, “Nerve growth factor is elevated in the CSF of patients with multiple sclerosis and central neuropathic pain,” was published…

Deep grey matter volume loss in the brain drives multiple sclerosis (MS) progression and disability, and is particularly evident in people with progressive forms of the disease, a retrospective multi-center study suggests. The study “Deep grey matter volume loss drives disability worsening in multiple sclerosis” was published in…

Editor’s note: Tamara Sellman continues her occasional series on the “MS alphabet” with this column referencing terms starting with the letter P. This post comes third in a series of seven. Symptoms of MS Pseudoexacerbation Sometimes a person with MS may feel they…

Editor’s note: Tamara Sellman continues her occasional series on the “MS alphabet” with this column referencing terms starting with the letter “P.” Last in a series of seven. Symptoms of MS Phosphenes If you’ve ever noticed bright, flashing, swirling, or circular light patterns on the…

The Food and Drug Administration (FDA) issued a safety alert about gadolinium, the dye that’s injected when our doctors order a brain MRI “with and without” contrast. The dye provides the contrast that “lights up” areas of MS inflammation in the brain. But the FDA advisory is…

Editor’s note: Tamara Sellman continues her occasional series on the MS alphabet with the second column in a series of seven referencing terms starting with the letter “P.” Symptoms of MS Ptosis Commonly referred to as “droopy eyelid,” ptosis (pronounced TOE-sis) sags…

As we all know, MS is difficult to diagnose. Put another way, it’s easy to misdiagnose. There’s no single diagnostic test for MS. Neurologists use their clinical examination, the patient’s medical history, and lab tests. They also rely on MRI imaging of the brain and sometimes of the…

Editor’s note: Tamara Sellman continues the MS alphabet with the first in a series referencing terms starting with the letter “P.”  Symptoms of MS Paroxysms This term describes sudden and violent occurrences of symptoms in those who are chronically ill. The symptoms…

The U.S. Food and Drug Administration (FDA) has updated a safety bulletin about gadolinium-based contrast agents (GBCAs), after studies raised new concerns about them. Doctors often use GBCAs to diagnose multiple sclerosis (MS), monitor disease activity and verify the effectiveness of MS therapies. Gadolinium is a metal ion, or electrically charged molecule, that…

A deterioration in multiple sclerosis patients' handwriting aligns with drops in their movement, sensory and cognitive skills, a study reports. MS includes loss of hand dexterity and finger movement control. This affects a patient's capacity to manipulate objects and coordinate hand movement, skills needed in handwriting. Previous studies have shown that MS patients had less handwriting rhythm and control than healthy people. This time researchers decided to compare the handwriting movements of both MS patients and healthy volunteers. The research involved 19 MS patients and 22 healthy age-matched controls. The team asked participants to write a specific sentence on a digitizing tablet. They discovered that the way MS patients wrote was much different than those of the controls. The patients took a lot longer to write each word and to achieve spacing between words. This led to them taking a much longer time overall to write a sentence than healthy people. In addition, analysis of handwriting strokes showed that MS patients' writing wasn't as smooth as that of healthy people. Researchers also found a correlation between patients’ movement abilities and cognitive status on the one hand and their handwriting ability on the other. The team said it believed “these findings might be very useful when planning rehabilitative task-oriented interventions focused on handwriting abilities.” In fact, rehabilitation specialists should consider evaluating “both the motor movement and the cognitive status of PwMS [patients with MS] in order to tailor the intervention."

Editor’s note: Tamara Sellman continues her occasional series on the MS alphabet with this column referencing terms starting with the letter “O.” Symptoms of MS Optic neuritis This is a common symptom of MS, though not everyone who experiences optic neuritis…

University of Huddersfield researchers have developed a blood test for diagnosing multiple sclerosis that avoids the invasive, painful process of collecting fluid from the brain and spine. The team at the British discussed the test in an article titled “Sphingosine and dihydrosphingosine as biomarkers for multiple sclerosis identified by…

(Editor’s note: Tamara Sellman continues her occasional series on the MS alphabet with this column referencing terms starting with the letter “N.”) Symptoms of MS Neurogenic bladder Many people with MS experience problems with the bladder. A neurogenic…

Multiple sclerosis patients should be routinely assessed for chronic and, especially, neuropathic pain in order to properly diagnose and treat this condition, which appears to directly affect the degree of a patient's disability, a new study reports. Pain is one of the most disabling clinical symptoms of MS, associated with suffering, distress, and lower quality of life. Many studies have investigated the prevalence of chronic pain in MS patients but with highly varying results: estimates range from 29 percent up to 92 percent. This disparity is likely due to methodological differences between the studies, as well as differences in the studied population. The result is the prevalence of pain in MS is still unclear, and underdiagnoses of pain in this patient population likely. Researchers in Italy conducted a single-center study to determine the prevalence and characteristics of chronic pain, defined as constant pain for more than three months, in a population of MS patients. Pain was evaluated using validated tools, and the results were analyzed in relation to clinical features such as disease duration and disability. In total, 374 MS patients with different disease severities were assessed for pain. Results found an overall prevalence of chronic pain of 52.1, most frequently affecting the lower limbs. Neuropathic pain, which refers to pain resulting from a lesion or disease impacting the sensory nervous system, was the most frequent type of chronic pain, affecting 23.7 percent of the patients analyzed. Pain intensity was also found to be significantly higher in patients with neuropathic pain compared to those with non-neuropathic pain. Researchers measured patients' disability using the Expanded Disability Status Scale. They determined that patients with chronic pain, and especially those with chronic neuropathic pain, had significantly higher EDSS scores (meaning greater disability) than those without such pain. Both these patient groups were also more likely to be on long-term pain medications: 33 percent of MS patients with neuropathic pain, and 24 percent of those with chronic pain. These results indicate that pain is underdiagnosed and undertreated in MS patients, and a factor that may contribute to increased disability. “Our results suggest that clinical disability is higher in MS patients with chronic pain and, in particular, in those with neuropathic pain,” the researchers concluded. “The present study supports the routine assessment of neuropathic pain in MS patients.”

Researchers further explored how our internal biological clock — known as circadian rhythm — influences immune system responses. Disruptions to that rhythm are associated with immune diseases like multiple sclerosis (MS), although in ways not fully understood and, the study suggests, may affect response to treatment. A natural 24-hour cycle that exists…

Blood levels of the nerve damage marker neurofilament light provide a reliable picture of multiple sclerosis activity in both the relapsing-remitting and progressive forms of the disease, a Swedish study reports. The University of Gothenburg researchers also discovered a close link between its levels in blood and spinal fluid. This means the…

A blood test may someday replace some of the magnetic resonance imaging (MRI) scans taken by people with multiple sclerosis (MS)  — offering an easy, cheap alternative for monitoring disease activity. A study by Norway’s University of Bergen found that blood levels of a factor called neurofilament light chain, released…

Editor’s note: Tamara Sellman continues her occasional series on the MS alphabet with the second of two columns about terms starting with the letter “M.” Symptoms of MS Marcus Gunn pupil This is a sign of emerging MS that may be discovered during what is known as the…

Hypochondria grabs, and it’s very difficult to shake. I spent the past three days eliminating potential reasons for struggling more than usual. Hopefully, it was a urinary tract infection (UTI) that was causing severe lethargy. It might have been at the start; I immediately jumped on a high ph…

Anniversaries often invoke reflection about the beginning, the journey, and where we now find ourselves. With luck, lessons will have been learned from the invariably good and bad experiences that couple any passage of time. In November 2010, I sat, eyes firmly affixed, as my neurologist read my…

A physiotherapist-supported exercise program using Nintendo Wii may be a feasible and cost-effective way of helping  people with multiple sclerosis (MS) be more physically active, researchers reported after performing a small pilot study. While findings showed some evidence that people improved — both in terms of self-reported health, gait and balance measurements — researchers underscored that more data needs to be gathered on the intervention’s effectiveness, as the study mainly intended to determine if such a program was feasible. Researchers at the Bournemouth University and Poole Hospital NHS Foundation Trust, both in the U.K., argued that a physical activity intervention using active gaming at home may overcome the many challenges MS patients face when attempting to be active. Barriers to it could be physical, but psychological factors, such as fear, embarrassment, or lack of confidence, can also prevent patients from attempting to increase their activity levels. Moreover, practical aspects — such as transport and cost — can hinder people from joining interventions. In the report, “Mii-vitaliSe: a pilot randomised controlled trial of a home gaming system (Nintendo Wii) to increase activity levels, vitality and well-being in people with multiple sclerosis,” researchers explained they used data generated in earlier Nintendo Wii studies to design an improved intervention program. Earlier studies showed that behavior change techniques, including motivational interviews and problem solving, would likely improve the impact of an intervention. These early studies also highlighted the importance of considering the functional levels, environment, and preferences of individual patients when prescribing a Wii-based program. The study (ISRCTN49286846), described in the journal BMJ Open, shows that among the 30 people who signed up, only two dropped out because of medical reasons. Patients either received the 12-month intervention, called Mii-vitaliSe, directly or after a six-month waiting period. Those on the waiting list group were given six months of intervention. Patients, who had low levels of physical activity when the study began, were instructed as to the benefits of physical activity and on how to use the Wii. During the personalized intervention, participants had access to regular support from a physiotherapist and were provided with a personal activity workbook, which aided participants in setting goals and monitoring progress, among other things. They were also asked to keep a log to track their activity, which showed an average use of the Wii two times per week, for 27 minutes each day. Results showed that patients who started the intervention immediately tended to report better physical activity levels, and better physical and psychological well-being. They also had numerical improvements in gait and balance. While no severe adverse reactions were seen, participants reported pain and worsening of scar tissue after some exercises, for which they received follow-up advice and care. The team also identified several problems or difficulties, including wrongly completed questionnaires, that will allow them to improve measurements once they launch a larger study. "Our study is the first to report on home-based use of the Wii for people with MS in the UK. Overall, findings from this study are promising and support proceeding to a full-scale trial of effectiveness and cost-effectiveness. We will refine the trial design, aspects of the intervention and finalize outcome measures in the light of our experiences from this pilot study" the researchers wrote.

Editor’s note: Tamara Sellman continues her occasional series on the MS alphabet with this first of two columns about terms starting with the letter M. Symptoms of MS Memory problems Memory loss is a common complaint for people with MS. Even for those with no physical or…

This weekend, as I turned back the clocks, searched for my Happy Light, and stared in dismay at the first snowfall of the season, I was reminded that it is the time to give my immune system some extra love. Autumn and winter ― with their requisite cold and…

Editor’s note: Tamara Sellman continues her occasional series on the MS alphabet with the second of two columns about terms starting with the letter “L.” Symptoms of MS Lhermitte’s Sign Otherwise known as “barber chair sign,” Lhermitte’s sign describes an intense shock-like pain racing down the back…

Nearly half of multiple sclerosis patients do not always report their relapses to healthcare providers, two surveys indicate. Mallinckrodt sponsored the surveys to better understand patients’ experience with relapses, which are sudden episodes of new symptoms or worsening of existing symptoms. The company presented the survey results at the 7th joint meeting…

This comes as no surprise to me and probably not to you. MS patients may not always contact their healthcare providers when they’re having a relapse. This information comes via a pair of surveys that were released at the recent ECTRIMS-ACTRIMS conference in Paris. In the first,…

After the first round of symptoms, multiple sclerosis can stay mild without causing major problems for decades, a 30-year British study indicates. Karen K. Chung of the University College London Institute of Neurology discussed the findings at the ECTRIMS-ACTRIMS meeting in Paris, which started Oct. 25 and runs until 28. His presentation was titled “Does…