Basic MSExplorer Blog

Kidney Stone Formation May Differ in MS Patients - 03/23/17 02:05:39pm

Kidney stone formers with multiple sclerosis are more likely than those without MS to form calcium phosphate stones and struvite stones, according to a new study.

In addition, among MS patients, use of intermittent straight catheterization or indwelling catheters are associated with an increased risk of stone formation.

In a retrospective study comparing stone formers with MS and a matched group of stone formers without MS (controls), a team led by Manoj Monga, MD, of the Cleveland Clinic Glickman Urological and Kidney Institute, found that the incidence of calcium phosphate stones and struvite stones was 42% and 8%, respectively, among the MS patients versus 15% and 3%, respectively, among controls. The between-group differences were statistically significant.

For the study, which was published online ahead of print in BJU International, the researchers identified 587 patients who had both MS and a history of stone formation. Of these, 118 had information on stone composition available. The investigators matched these patients by sex, age, and body mass index (BMI) to 230 controls. The MS patients were significantly more likely than controls to have undergone percutaneous nephrolithotomy (25% vs 12%) and cystolithopaxy (16% vs 3%).

The researchers also compared a matched group of patients who had a complete 24-hour urinary stone panel analysis (61 MS patients and 120 controls). Serum laboratory measures were similar between the groups except for sodium levels, which were slightly lower in the MS patients (139 vs 140 mmol/L). The groups were similar with respect to urinary pH, volume, creatinine, calcium citrate, oxalate, sodium, and uric acid. The researchers found no significant differences in hypocitraturia, hyperoxaluria, hypercalcuria, and hyperuricosuria.

Additionally, Dr. Monga and his colleagues identified 358 MS patients with stone disease who had information about bladder emptying techniques and mobility within 1 year of their stone episode. They matched these patients to 358 MS patients without stone disease. After controlling for age, gender, BMI and mobility, patients who required ISC or an indwelling catheter (either a Foley catheter or suprapubic tube) had a significant 3.5 times and 9.8 times greater odds of having stone disease compared with those who could void spontaneously.

The development of MS-related voiding dysfunction requiring the use of ISC, suprapubic tubes, or an indwelling Foley catheter appears to be a risk factor in the development of stone disease, the authors concluded. The findings suggest the importance of preventive approaches and prompt treatment of urinary tract infections in this population. 

Via Renal & Urology News

Swallowing Problems in MS - 03/22/17 02:05:07pm

Swallowing difficulties and reduced cough are a major, yet commonly overlooked, issue in patients with multiple sclerosis and other brain conditions, according to Dr. Don Bolser, a University of Florida (UF) professor.

Pharmaceutical companies haven’t recognized the importance of preventing bits of food and drink from getting into the lungs while breathing, Bolser said. More research is needed on this issue, he said in a UF News story.

Bolser, a neurologist and neuroscientist, is studying how cough is controlled by the nervous system. He said cough is tightly linked to swallowing — a reflex that healthy people do not pay attention to until they have something go down the wrong pipe.

During swallowing, muscles are coordinated so that the windpipe closes as food or drink is moved from the mouth to the esophagus. While a swallowing problem might intuitively be viewed as difficulty moving food from the mouth to the esophagus, lack of muscle coordination also puts millions of people with various brain conditions at risk of aspiration pneumonia.

Aspiration pneumonia occurs when pieces of food and drink enter the lungs. A weakened cough reflex — also commonly seen in patients with brain damage — prevents a patient from getting the food out of the lungs.

Bolster said studies report aspiration pneumonia death rates of over 60 percent. And aspiration pneumonia strikes in about half of long-term care residents. The treatment is expensive, Bolster added, with each hospital admission costing about $17,000.

Despite these discouraging statistics, Bolster said no pharmaceutical companies are developing drugs to restore weakened swallowing and cough.

The most accepted approach to dealing with impaired swallowing is a recommendation that patients eat thick foods. They are easier to swallow and less likely to enter the airways.



MS Pipeline Drug: ALKS 8700 - 03/20/17 02:05:05pm

Alkermes has started a Phase 3 clinical trial evaluating ALKS 8700, the oral monomethyl fumarate (MMF) prodrug it is developing for the treatment of relapsing forms of multiple sclerosis (MS).

The multicenter, double-blind, active-controlled trial (NCT02634307) will examine whether the gastrointestinal tract can tolerate ALKS 8700 better than Tecfidera (dimethyl fumarate). The 420 patients with relapsing-remitting MS (RRMS) will receive either 462 mg of ALKS 8700 twice a day or 240 mg of Tecfidera.

A prodrug is a compound the body converts into an active therapy. U.S. regulators have already approved Tecfidera, while ALKS 8700 is still in the treatment-candidate stage.

“ALKS 8700, a MMF prodrug with distinct physical-chemical properties, is designed to provide therapeutic concentrations of MMF in the body and offer differentiated features as compared to the market leader, dimethyl fumarate, TECFIDERA, which is associated with gastrointestinal side effects. These adverse events can lead to treatment interruption or discontinuation for patients with MS,” Elliot Ehrich, MD, Alkermes’ chief medical officer, said in a press release.

“We believe ALKS 8700 may represent a valuable new option for patients suffering from MS who want the efficacy of fumarate therapy with more favorable gastrointestinal tolerability,” Ehrich added.



Multiple Sclerosis Friendly Recipes - 03/17/17 02:05:34pm

As is customary, every Friday we will provide you with 3 easy to prepare MS friendly recipes to try this coming week.

Crab Stuffed Shrimp

Shrimp and crabs are two strange creatures, but boy do they taste good when combined together. Don’t get fooled by the sophisticated look of this appetizer either, it’s still very easy to prepare and not as expensive as many would think.

See recipe here. 

Ground Beef Tacos

To follow up with a delicious use for some Paleo tortillas, here’s a basic taco recipe that you can adapt almost endlessly to suit your personal tastes.

See recipe here.

Strawberry Applesauce

Use this quick recipe to preserve the apples you buy now for a cold day down the line. If you freeze it after cooking, it’ll last for months and months; pull it out in January or February when life is cold and bleak and needs a little sweetness to tide you through the winter.

See recipe here.

Acorda Launches Interactive and Talking ‘MS Awareness Facts’ Alexa Service for March - 03/16/17 02:05:59pm

In recognition of multiple sclerosis (MS) awareness month, Acorda Therapeutics has launched its Alexa skill, called MS Awareness Facts.  The interactive voice-controlled service allows users to ask Amazon Alexa for information regarding MS and its debilitating symptoms.

Amazon Alexa is a cloud-based service that enable customers to interact in an intuitive way — by speaking to it. Through voice commands, users pose questions to Alexa, such as “Alexa, start MS Awareness” or “Alexa open MS Awareness.” Alexa will arbitrarily choose from one of nearly 50 facts and tips about MS in the system, and read the response aloud.

Because it works in the cloud, Alexa is also always getting smarter. The more the customers who use it, the more it adapts to speech patterns, vocabulary, and personal preferences.

“We’re proud to be at the forefront of using this new technology to connect with patients,” Michael Russo, executive director, corporate digital strategy & innovation, said in a press release. “Education is an important component of each person’s fight against multiple sclerosis. As we move towards becoming an increasingly digital society, it’s important that we provide solutions that match the way people live and work, and in this case that means voice search.”

Acorda is also the developer of a team on Charity Miles, a free app for iPhone or Android. The app allows users to raise funds for charity through activities such as biking, running, or walking. Users can be part of Acorda’s team and download the app by searching for #MSAwareness. Members of the Acorda team may choose an MS charity to receive the money raised.

With March being the MS Awareness Month, organizations including the MS Association of America, the National MS Society, and the MS Foundation are devoting efforts to calls for awareness about MS and to expanding knowledge, support and understanding of this debilitating disease that affects more than 2.3 million people worldwide.


Plant-Based Diet Could Limit MS Symptoms - 03/15/17 02:05:50pm

An internist who changed her career and turned around her health after discovering the peer-reviewed power of a plant-based diet, Dr. Saray Stancic comes to Maine next month to deliver the keynote address at the annual Maine Nutrition Council conference. Her speech will focus on her personal journey and the shift she says needs to happen in health care.

“What I speak to is evidence-based,” Stancic told me by phone from her practice in Ridgewood, New Jersey. “We need to get this message out to everyone. We need to get this into the curricula of U.S. medical schools. This is going to require society to change.”

In addition to the keynote address, Stancic will deliver a talk on managing autoimmune disease with diet, which led to her entering the field of plant-based medicine. It happened years after she was diagnosed with multiple sclerosis at age 28 while working an overnight shift at the hospital.

By 2003, Stancic had been suffering from MS for years, needed a cane or crutch to walk and was taking a dozen medications a day to manage the condition. One day, she came across a study that found a blueberry-rich diet helped reduce fatigue in MS patients. She was skeptical – “In all my training, never did any mentors or professors mention a connection between diet and disease,” Stancic said – but the idea that they might be linked persisted.

“I started to read the peer-reviewed medical literature, and I found that diet was the most important variable in preventing disease and treating chronic disease,” Stancic said.

She adopted a plant-based, vegan diet herself, and even though MS is considered an incurable, degenerative disease, her symptoms gradually faded. Soon she no longer needed a crutch to walk. She stopped talking her medications. Six years after she became a vegan, she was able to run a marathon.

Meanwhile, she was working as an infectious disease specialist and often consulted with patients who had diabetes and other chronic conditions. She began to share information with them about the impact of a plant-based diet, and she saw that their own conditions improved when they changed their own diets.

READ MORE Via Portland Press Herald

6 Common Symptoms of Chronic Fatigue - 03/15/17 02:05:21pm

With tips from the pros at, we’ve put together a list of six ways that chronic fatigue can affect sufferers on a daily basis.

You feel extremely exhausted- Everyone experiences feeling tired and worn out from time to time but chronic fatigue takes this a step further. People will often avoid doing things they enjoy because they don’t have the energy to go out or even get off the sofa. Getting through a day at work or school will leave them feeling extremely exhausted as though they have gone through their energy reserves and have nothing left.

You can’t get a good night’s sleep- You would imagine that fatigue could be solved with sleep, but patients who suffer from chronic fatigue often have trouble falling asleep or wake constantly throughout the night. This lack of sleep (or disturbed sleep) only adds to the problem and makes the fatigue worse. Even if you do get to sleep, many find that they don’t feel any better when they wake up.

You can’t concentrate- Fatigue also affects people cognitively. Many find it difficult to concentrate, that they forget things, and are easily distracted. Brain fog is a common symptom associated with fatigue and many report being unable to communicate well, often not being able to find the right words when speaking or forgetting people’s names.

Simple tasks zap your emotional energy- Completing simple tasks when you have chronic fatigue can seem like climbing a mountain. As well as being physically taxing, fatigue can also be emotionally and mentally taxing. Stressful situations may have you feeling completely overwrought or agitated.

You can’t balance- Extreme fatigue can also cause balance issues. People often report feeling unstable when standing upright, which can be relieved by lying down. Although there is no proven reason for this sensation, it’s thought that it could be due to less blood flowing to the brain when a person is standing up.

You’re constantly in pain- Chronic fatigue can also bring about pains and aches. People with chronic fatigue are more likely to suffer from headaches, joint aches, and muscle soreness.


Predicting Who Will Get Progressive MS - 03/13/17 02:05:16pm

In a recent study, researchers report they found a way for early diagnosis of MS in the progressive category. In a group of 155 people ages 50 and older, 30 percent progressed to secondary progressive MS by the five-year mark of the study.

The two things in common with all those who progressed? Fatigue and weak or spasmodic legs. 

“Study participants with those symptoms were more likely to progress from relapsing-remitting MS to secondary progressive MS within five years,” said study author Dr. Bianca Weinstock-Guttman, of the Jacobs School of Medicine and Biomedical Sciences at the University of Buffalo in New York, and a member of the American Academy of Neurology. “Better understanding who is at high risk of getting worse may eventually allow us to tailor more specific treatments to these people.” 

Both fatigue and leg issues can be common for people with MS. Excessive fatigue is considered the most disabling symptom. It occurs in 80 percent of people with MS, according to the National Multiple Sclerosis Society.

In addition, fatigue can lead to exacerbated symptoms such as poor cognitive function. Cog-fog, as it is often called, causes issues with information processing speed, attention, motor function, and memory.

There are not a lot of effective treatments for fatigue, especially without strong side effects. However, researchers are not giving up.

In a recent study, researchers looked at the efficacy of a personalized neuromodulation treatment, basically a form of electroconvulsive therapy (ECT). The study suggested that interventions could help relieve debilitating symptoms by targeting key areas of the brain. 

While the industry has seen many improvements for relapsing MS there have been little for those with progressive MS. North Africans in France progressed significantly faster than Caucasian people with MS.

In Ireland, the typical person with MS is age 54 and older. There was a preponderance of men and a greater number of people with motor onset compared with other subgroups of people with MS.

The increasing number of successful studies looking into progressive MS is hopeful, experts say.

“While more research needs to be done, this study brings us closer to understanding which older adults with MS may be at higher risk of getting worse,” said Weinstock-Guttman.

Via HealthLine

Muscle Health Test Shows Importance of Exercise in Multiple Sclerosis - 03/13/17 12:05:47pm

A new test can show how exercise is benefiting people with multiple sclerosis (MS) and other neurological conditions.

The evaluation of muscle health in individuals with MS, spinal cord injuries and other severe nerve damage conditions is usually done with magnetic resonance imaging (MRI) and other expensive equipment.

Researchers in the kinesiology department at the University of Georgia (UGA) College of Education developed a non-invasive test capable of measuring increases in muscle endurance. That is a muscle’s ability to exert force, consistently and repetitively, over a period of time after exercise.

To measure muscle endurance, the researchers used an accelerometer in conjunction with a device that uses low-level electronic pulses to make muscles move. An accelerometer records acceleration in movement.

Professor Kevin McCully said the results were beyond what the team anticipated in a clinical population that is usually not tested for muscle health. “I’m a real fan of the test,” he said in a news release. “It has a chance to transform the way people study muscles in clinical populations because it’s so simple, easy and well-tolerated.”

McCully is head of UGA’s Exercise Muscle Physiology Laboratory at UGA. One focus of its research is developing non-invasive approaches to studying skeletal muscle metabolism, blood flow and oxygen utilization. Another is developing innovative ways to improve physical activity levels and exercise in people with chronic illnesses and injuries.

Brad Willingham, a kinesiology doctoral student who helped to develop the test, said he has already seen impressive results in individuals with MS. His results have been recognized by the American College of Sports Medicine, which granted him the best doctoral poster award at a convention in February.

Using a special anti-gravity treadmill, Willingham had patients exercise twice a week for eight weeks. Then he used the new test to evaluate the increase in patients’ muscle endurance after exercise. He found that exercise induced a remarkable increase in the patients’ muscle health.

“If we’re giving them therapy, we’re using this to tease out the mechanism of why it’s working,” Willingham said. “We strongly believe that some benefits of therapy are related to muscle plasticity, or the ability of the muscle to adapt to exercise, and that’s essentially what this test is showing.”


Multiple Sclerosis Friendly Recipes - 03/10/17 12:05:55pm