MS Research Roundup March 2011

So many interesting bits of research reported in the last month! I'll try to strike a balance between not missing out anything really interesting, and not making this post ridiculously long.

As far as I can, I'll work from studies relating to risk factors for MS, through symptoms, to treatments.

An important Australian study has found that people who spend more time in the sun, and those with higher vitamin D levels, may be less likely to develop MS. The study was important because previous ones had looked only at populations who already had established MS. This looked at people experiencing "first events", that is preliminary symptoms likely to lead to a diagnosis of MS. These results add to the growing evidence linking vitamin D deficiency with the onset of MS.

Meanwhile, American researchers have found that people with confirmed MS tend to have lowered levels of an important neurotransmitter called noradrenaline. Noradrenaline performs a number of roles in the body: among them are preventing inflammation and stress to neurons, and preserving the integrity of the blood-brain barrier. If the blood-brain barrier is not maintained, immune system cells can get through from the bloodstream into the brain and cause damage to brain cells.

The main source of noradrenaline in the brain is a structure known as the locus coeruleus (LC), deep in the brain.There is existing evidence that the LC is damaged in Alzheimer's and Parkinson's diseases. The researchers in this study believe that damage to the LC is also involved in MS.

Cognitive (thinking) problems are common in MS. A group of Austrian researchers used fMRI to investigate whether the brains of people with MS reorganise themselves to try to overcome these problems. They compared groups of people at different stages of MS with healthy controls, and found that as the disease progressed different parts of the brain were activated on dealing with a relatively simple thinking task. The cognitive effects of MS would be far worse if it were not for the brain adjusting in this way.

Still on thinking skills, it will be no surprise to many of those with MS reading this that warm or hot weather makes it harder for a lot of us to think and concentrate. Still, it's useful to have medical evidence proving it! There was already evidence that disease activity and lesion growth tend to be greater in warm weather, but this is the first time that thinking skills and weather have been investigated. The researchers found that people with MS scored (on average) a remarkable 70% better on cooler compared to hotter days of the year.

Another very common symptom in MS is depression. People with MS are 50% more likely than the general population to have depression over the course of their lifetime. It's never been clear whether this is a physical effect of the MS on the individual's brain, or the psychological effect of having a major and unpredictable progressive illness. Now American researchers have observed that people with MS appear to have shrinkage in a particular part of the brain called the hippocampus, which regulates mood and memory as well as other functions. There was also increased activity in an area of the brain that controls the body's reaction to stress.

And so on to treatments... 

Core stability refers to the stability of the abomen and pelvis. For someone to make a movement - for instance of a leg - their core first has to be stable, or they will become unbalanced and risk falling. The same applies to upper limb movements. A British study found that core stability exercises improved walking and reach for ambulant (able to walk) people with MS.

MS drug therapies are based round the theory that cells of the body's own immune system - specifically, T-cells - are attacking the body's own cells rather than foreign substances. It has never been clear, however, whether each attack in RRMS involved a different type of T-cell or not. If different types are involved, the T-cells already in the body would not be a suitable target for therapy. Now researchers in America have confirmed that it is the same T-cells that cause each relapse episode, and therefore that MS drug therapies are following the correct therapeutic approach.

One of these drug therapies is interferon-β. People may have to stop taking interferon-β if their body develops antibodies to it - a serious annoyance if they have been responding well to the drug. Now American researchers have discovered a drug, dodecylmaltoside, which it appears may slow down or stop the development of antibodies to interferon-β. It is only being tested in animals at present, but will hopefully progress to use in humans.

And finally, some excellent news about the relatively new drug therapy Tysabri, in a German study. An evoked potential test measures the time it takes for nerves to response to stimuli, and is a common test in the diagnosis of MS. The researchers measured evoked potentials in their patients one year before they started on Tysabri, on the day they started, and a year later. They found that patients had stable or even improved readings, showing that their disease progression had apparently been halted.

Right, sorry for that marathon...let's see what next month brings!