Hold on to your pillows, because it turns out that catching those precious Z’s might be even more important than we thought—especially for women dealing with multiple sclerosis (MS) and other chronic conditions!
According to new research from the University of Michigan Health, poor sleep health could be a sneaky culprit behind declining mobility in older women. Published in Sleep Epidemiology, the study focused on women with chronic conditions like diabetes, osteoarthritis, and Multiple Sclerosis. It found that those with symptoms of obstructive sleep apnea (a common sleep disorder) were more likely to experience mobility issues down the road.
“Sleep troubles often get brushed off as just part of aging or chronic illness,” says Dr. Tiffany J. Braley, associate professor of neurology and director of the multiple sclerosis and neuroimmunology division at the University of Michigan Health. But guess what? These sleep woes might be causing mobility problems, not just tagging along for the ride.
Dr. Daniel Whibley, assistant professor of physical medicine and rehabilitation, adds that treating sleep issues can improve daily movement. “Our clinical experience shows that how well someone sleeps can directly impact their ability to stay active and manage their condition,” he says.
The study found that women with signs of obstructive sleep apnea, poor sleep durations, and a sense of inadequate sleep were more likely to need mobility aids like canes or wheelchairs in the future. But there’s a silver lining: identifying and treating sleep problems early on could help prevent these issues.
So, if you’re dealing with a chronic condition like MS, don’t snooze on your sleep health! Speaking up about sleep troubles and seeking help from a specialist could make a world of difference in staying mobile and active.
Sweet dreams, and may they lead to a brighter, more mobile future!
Multiple sclerosis (MS) is a challenging disease that affects individuals differently. Unfortunately, studies show that Hispanic and Black people with MS often experience higher levels of disability compared to white people, yet they are less likely to receive prescriptions for newer, more effective treatments. However, a recent study from Kaiser Permanente Southern California, presented at the American Academy of Neurology’s 77th Annual Meeting, introduces a promising solution to reduce these disparities through a straightforward treatment algorithm.
The Study’s Objective
The study aimed to identify a method to increase the use of highly effective disease-modifying treatments among all racial and ethnic groups, thereby improving health outcomes for people with MS. Dr. Annette Langer-Gould, MD, PhD, the study’s author, expressed excitement about the potential of the algorithm to rapidly increase medication use across diverse populations, ultimately enhancing their health.
How the Algorithm Works
The treatment algorithm utilizes readily available clinical factors such as weakness and bladder dysfunction and considers social factors like out-of-pocket costs, transportation barriers, childcare, and work schedules. Importantly, it does not take race and ethnicity into account. By focusing on these factors, the algorithm helps match individuals to newer treatments that are highly effective in reducing MS relapses, such as natalizumab, rituximab, and ofatumumab.
Key Findings
The study involved 1,741 Hispanic people, 978 Black people, and 3,400 white people with MS who were receiving disease-modifying therapies. Researchers discovered notable differences in relapse rates among these groups before the implementation of the algorithm. Hispanic people had a higher annual relapse rate than white people, with 245 relapses compared to 156 relapses per 1,000 person-years. Black people also had higher relapse rates than white people during one year of the study.
Impact of the Algorithm
Over the 12-year study, the researchers observed an increased use of highly effective therapies across all three groups, particularly rituximab, which is more affordable and can be administered less frequently. For Hispanic people, there was an 89% increase in the use of highly effective therapies, an 87% increase for Black people, and an 83% increase for white people.
After adjusting for age and sex, the researchers reported a significant decline in the annual relapse rate for each group. Hispanic people experienced a 90% reduction in relapses, white people saw an 86% reduction, and Black people had an 82% reduction. By the end of the study, there was no longer a significant difference in the annual relapse rate among Hispanic, Black, and white people.
Encouraging Results
Dr. Langer-Gould highlighted the success of the program, stating, “It is encouraging that our program led to more effective treatments for people with MS resulting in a large reduction in relapse rates among Hispanic, Black, and white people.” The study demonstrated that using an algorithmic approach to increase the use of highly effective medications, particularly affordable ones like rituximab, can reduce racial and ethnic disparities in MS and greatly improve outcomes for all individuals with relapsing forms of MS.
Limitations and Future Directions
While the study showed promising results, it did not assess long-term disability or the benefits of starting highly effective treatments at diagnosis compared to delaying them until later in the disease course. Further research is needed to explore these aspects and continue improving MS treatment strategies.
Conclusion
The introduction of a simple treatment algorithm marks a significant step forward in reducing treatment disparities for Hispanic and Black people with MS. By leveraging clinical and social factors, this approach ensures that more individuals receive the best possible care, ultimately leading to better health outcomes for all.
Researchers at the National Institutes of Health (NIH) have created a revolutionary four-dimensional brain map that uncovers how multiple sclerosis (MS) lesions form, offering a window into the disease’s early stages. This groundbreaking study, published in Science, could help identify new targets for MS treatments and brain tissue repair.
A Deeper Look into Multiple Sclerosis
Multiple sclerosis is an autoimmune disease where the immune system attacks the protective covering of nerve fibers, called myelin, leading to inflammation and the formation of lesions or plaques in the brain. These lesions disrupt the normal functioning of the nervous system, causing a wide range of symptoms.
The NIH research team, led by Dr. Jing-Ping Lin and Dr. Daniel S. Reich, combined MRI imaging with brain-tissue analysis to track the development of MS-like lesions in an animal model. They discovered a new MRI signature that can detect brain regions at risk for damage weeks before visible lesions appear. Additionally, they identified “microenvironments” within affected brain tissue, revealing patterns of neural function, inflammation, immune responses, and repair mechanisms.
Why the Marmoset Model?
To better understand MS, the researchers used marmosets, a type of nonhuman primate with brain structures more similar to humans than mice. This model allowed them to create multiple lesions that closely resemble those seen in human MS, providing real-time insights into the disease’s progression.
One key finding was the role of a specific type of astrocyte, a support cell in the brain, that activates a gene called SERPINE1 (also known as PAI1). These astrocytes cluster near blood vessels and fluid-filled brain ventricles, signaling future lesion development and influencing the behavior of other cells involved in inflammation and myelin repair.
Implications for MS and Beyond
This study’s findings could have far-reaching implications for MS and other brain injuries, such as traumatic brain injury, stroke, and inflammation. Understanding the early events that occur after inflammation can help identify MS disease activity sooner and develop treatments to slow or stop its progression.
The researchers are now working on a new model of a different autoimmune condition affecting brain borders and expanding their data set to include aged animals. This could improve our understanding of progressive MS, a stage of the disease with significant unmet therapeutic needs.
A high intake of lean and oily fish might just be the key to slowing the progression of disability in people with multiple sclerosis (MS). This exciting possibility comes from a recent study published online in the Journal of Neurology Neurosurgery & Psychiatry.
Researchers have highlighted the anti-inflammatory and neuroprotective properties of nutrients found in fish. These properties may be essential in managing MS, emphasizing the potential significance of diet in managing this disease.
Emerging evidence suggests that diet can play a role in the development of inflammatory diseases, including MS. Although past studies have linked fish consumption to lower disability levels in MS patients, very few have explored whether fish consumption might actually slow down the progression of disability.
To delve deeper into this, researchers drew on data from 2,719 newly diagnosed participants in the Epidemiologic Investigation of Multiple Sclerosis (EIMS) study. This Swedish nationwide population-based case-control study included participants with an average age of 38, recruited between April 2005 and June 2015.
Upon joining the study, participants provided information on their environmental exposures and lifestyle habits, including their fish consumption. Fish intake was categorized as never or seldom, 1 to 3 times a month, and weekly. The fish were scored from 2 to 6, depending on whether participants ate lean or oily fish, or both.
The progression of their disease was tracked for up to 15 years using the Expanded Disability Status Scale (EDSS) through the Swedish MS Registry. Confirmed disability worsening was defined as an increase in the EDSS score of at least one point from baseline, sustained across two further check-ups at least six months apart.
The study found that higher fish consumption at diagnosis was associated with a 44% lower risk of confirmed disability worsening. Additionally, there was a 45% lower risk of progressing to EDSS 3 and a 43% lower risk of progressing to EDSS 4 compared to those who ate little or no fish.
Moreover, the trend analysis indicated that the more lean and oily fish consumed, the lower the risk of confirmed disability worsening and progression to EDSS 3 and 4.
In 2021, 1,719 participants completed an online follow-up questionnaire to assess changes in fish intake over time. About 24% of participants had changed their fish consumption—288 had increased it, while 124 had decreased it.
Those who increased their fish consumption score within five years after diagnosis had a 20% lower risk of confirmed disability worsening compared to those who continued eating little or no fish.
Even though only 16 participants increased their fish consumption from a baseline score of 2 to a score of 5-6, they had a 59% lower risk of confirmed disability worsening compared to those who maintained the lowest level of consumption.
The findings remained consistent even when considering other factors such as physical activity, weight (BMI), smoking, alcohol intake, and sun exposure. The results also held true after further adjusting for vitamin D levels.
While this study is observational and cannot establish cause and effect, it opens the door for further research to validate these findings and investigate the underlying biological mechanisms.
The researchers suggest that while omega-3 fatty acids, found predominantly in oily fish, may contribute to reduced disability progression, other factors may also play a significant role. One such factor is taurine, an amino acid abundant in fish and seafood. Taurine, the most plentiful free amino acid in the brain, has diverse cellular functions, including antioxidative and anti-inflammatory effects. This makes it a potential therapeutic agent for neurological disorders.
In conclusion, the results underscore the potential role of diet, especially fish consumption, as a modifiable factor that could complement existing therapeutic strategies for MS. So, incorporating more lean and oily fish into the diet could be a game-changer for managing MS progression.
A recent registry study conducted by the University of Oulu has revealed significant improvements in the early-stage treatment of relapsing-remitting multiple sclerosis (MS) in Finland between 2013 and 2022. During this period, the approach to diagnosing and treating MS has undergone a remarkable transformation, aligning with the latest scientific evidence and benefiting Finnish patients immensely.
Key Findings
Faster Diagnoses: The average time to diagnose relapsing-remitting MS has reduced from ten months in 2013 to just five months today, allowing for earlier treatment initiation.
Advanced Treatment Practices: Highly effective medications, which have a stronger impact on the immune system, are now being used as first-line treatments instead of starting with moderately effective medications.
Resilient Healthcare: Despite challenges like resource constraints and the COVID-19 pandemic, there have been minimal delays in MS diagnosis and treatment.
Research Insights
Principal Investigator Mervi Ryytty from the University of Oulu and Oulu University Hospital highlighted that Finnish neurological patient care now closely follows international research findings, which significantly benefits patients. Additionally, Medical Manager Elina Jokinen from Novartis emphasized the importance of understanding the evolution of MS treatment in Finland, showcasing successful collaboration between pharmaceutical companies and researchers.
Study Details
The research utilized secondary data from the Finnish MS Register, the drug prescription registry of Finnish Insurance Institution (Kela), and the National Care Register for Health Care HILMO. The study was a collaborative effort between the University of Oulu, Novartis Finland Oy, and StellarQ Oy, with contributions from researchers at the Universities of Turku and Helsinki.
Understanding Multiple Sclerosis
Multiple sclerosis (MS) is an autoimmune disease where the immune system attacks the central nervous system. Relapsing-remitting MS is the most common form, typically affecting young adults. Although MS cannot be cured, its progression can be slowed with medication, aiming to maintain the patient’s functional ability and quality of life for as long as possible.
Continuous Advances
MS remains an active field of research, with many new treatments introduced in the past decade. Early intensive treatment has been shown to improve the prognosis of relapsing-remitting MS, according to recent international studies.
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