Multiple Sclerosis

Posted on Multiple Sclerosis

Good News for People with MS: COVID-19 Doesn’t Worsen Symptoms

Leading health organizations are urging people to get a flu shot if they haven’t already done so. Compared to last year’s mild flu season,[1] the U.S. has already seen more than three times the number of flu-related deaths.[2] While seasonal influenza activity shows a declining trend,[3] flu season is expected to continue well into spring. The American Heart Association®, the American Lung Association® and the American Diabetes Association® are teaming up to send a message to people who have not yet received this season’s flu vaccine: It’s not too late to protect yourself and others, some of whom are more vulnerable to the dangers of the flu, by getting your flu shot. While no one wants to experience the misery of the flu, for many people with chronic conditions, the flu causes serious complications, leading to hospitalization or in some instances death. According to the Centers for Disease Control and Prevention, in recent years, about 9 out of every 10 people who were in the hospital due to the flu had at least one underlying medical condition.[4] The underlying health conditions that commonly put adults at higher risk of complications from the flu include heart disease, history of stroke, type 1 or type 2 diabetes, obesity and chronic lung disease such as asthma, cystic fibrosis and chronic obstructive pulmonary disease (COPD).[5] “Adults who have cardiovascular disease face a significant risk of complications if they contract the flu,” said Eduardo Sanchez, M.D., M.P.H., FAHA, the American Heart Association’s chief medical officer for prevention. “For example, if you have heart disease and you’re not vaccinated against the flu, you are six times more likely to have a heart attack within a week of infection. The flu vaccine can be doubly protective—from bad flu and from its complications. While earlier in the season is ideal, we have a lot of flu season left, and it’s better to get one now than not at all.” With the U.S. flu season typically peaking mid-to late winter, between December and February,[6] experts say those who haven’t gotten the flu shot yet should do so as soon as possible. By getting vaccinated, individuals are not only protecting themselves but those around them who may not be able to get vaccinated or who have a weakened immune response to vaccines. “Even a minor respiratory virus can be hard on someone with lung disease, and the flu is especially challenging,” said Dr. Albert Rizzo, M.D., chief medical officer for the American Lung Association. “We want to reiterate that not only should people with any chronic illness get a flu shot, but their loved ones and friends should also protect them by getting the flu vaccine. It’s imperative that we slow the spread of the flu this year as much as possible to continue to decrease the number of cases and hospitalizations, and to protect our most vulnerable loved ones.” Many of these same chronic conditions also put individuals at higher risk of complications from COVID-19, so it is important to also stay up to date on the COVID vaccine. Health professionals recommend the flu shot for anyone 6 months of age and older, and say it is safe to get a flu vaccine along with a COVID-19 booster. They also urge those 65 and older to ask about the flu vaccines recommended for their age and get the best one that’s available at that location at that time. “In recent years, almost a third of the people hospitalized due to the flu had diabetes,”[7] said Robert Gabbay, M.D., chief scientific and medical officer for the American Diabetes Association. “The impact from any illness can pose a threat to someone with diabetes, especially considering many people who live with diabetes have other complications like heart disease and kidney disease. Staying up to date on all annual vaccines and the COVID-19 vaccine is recommended for everyone who is eligible, especially those living with diabetes and other chronic illness.”

A recent study brings good news for people with multiple sclerosis (MS): having a COVID-19 infection does not make MS symptoms or disability worse.

“Infections can sometimes lead to more disability in people with MS,” said Dr. Amber Salter from UT Southwestern Medical Center in Dallas. “However, our study found this is not the case with COVID-19. People with MS don’t need to worry about long-term worsening of their symptoms after a COVID-19 infection.”

The study followed 2,132 adults with MS, with an average age of 65, over 18 months. Participants reported whether they had ever had a COVID-19 infection, which was confirmed by a test. Among them, 796 had COVID-19, while 1,336 did not.

Participants also rated the severity of their MS symptoms, including walking, hand function, pain, fatigue, and memory, at least six times during the study. They scored their disability based on daily activities like walking or standing.

After accounting for factors like age, race, and gender, researchers found that MS symptoms increased very slightly over time—by just 0.02 points per month—regardless of whether participants had COVID-19. There was no difference in MS symptom severity between those who had COVID-19 and those who didn’t. The same was valid for disability levels.

“Our study shows that COVID-19 infection did not lead to immediate changes in symptom severity or disability. It also did not alter the MS symptoms or disability trajectory for more than a year and a half after the infection,” said Salter. “While our study mainly looked at older people, these findings help us better understand how COVID-19 affects people with MS.”

One limitation of the study is that COVID-19 tests can sometimes give incorrect results, and some people may have had COVID-19 without knowing it.

This research offers reassurance to people with MS and highlights the resilience of their health in the face of COVID-19.

Posted on Cognitive dysfunction, Multiple Sclerosis

5 Common Symptoms of MS That I Have and Tips to Help Manage Them

When we live with MS, there can be dozens of symptoms, and they can interfere with our lives, our ability to work, and our quality of life. In this video, I am going to go over five common MS symptoms that I have and some tips and evidence-based ways to help us manage symptoms and improve our quality of life. These symptoms include fatigue, Uhthoff’s phenomenon, cog fog, spasms, and weakness.

Posted on Alzheimer's, Multiple Sclerosis

How Brain Inflammation (in MS) Affects Behavior in Men and Women Differently

An Australian-first study has lifted the lid on how couples living with rheumatoid arthritis cope with the debilitating disease finding that those who cope with problems together had less psychological distress and better relationships.

For people with multiple sclerosis (MS), understanding how brain inflammation impacts behavior can provide insight into some of the common symptoms they experience. New research from the University of Technology Sydney (UTS) sheds light on how inflammation in the hippocampus—a part of the brain critical for memory and emotions—affects motivation and behavior, with clear differences between males and females.

What’s the Connection Between Brain Inflammation and Behavior?

The hippocampus is central to memory, learning, and emotional regulation, but it’s also affected by inflammation in diseases like MS, Alzheimer’s, and depression. This inflammation, called neuroinflammation, often results in symptoms like:

  • Apathy
  • Struggles with daily activities
  • Changes in food preferences

Interestingly, these symptoms tend to be more severe in women than in men.

“While inflammation in the hippocampus isn’t the sole reason for behavior changes, it likely sets off a chain reaction in the brain that influences how we think and act,” explained Dr. Laura Bradfield, Director of the Brain and Behaviour Lab at UTS.

What Did the Study Find?

Using mice, researchers at UTS simulated neuroinflammation by introducing a bacterial toxin called lipopolysaccharide into the hippocampus. This toxin triggers an immune response in the brain, mimicking the inflammation seen in diseases like MS.

The findings were fascinating:

  • In both male and female mice, activity and movement levels increased.
  • Females showed more significant changes in food-seeking behaviour, suggesting inflammation affects their motivation differently.

The research also highlighted the role of microglia and astrocytes, two types of brain cells that interact with neurons during inflammation, showing how complex these changes are at a cellular level.

Why Do Women Experience Stronger Effects?

The study suggests that hormones like estrogen might play a role in how neuroinflammation affects the brain. These sex-specific differences could explain why women with MS often experience more severe cognitive and behavioural symptoms.

What Does This Mean for MS Patients?

For those living with MS, this research offers hope for more personalized treatments. By targeting hippocampal neuroinflammation, future therapies might alleviate symptoms like memory issues, apathy, and difficulty with daily tasks—potentially improving brain health, especially for women.

“These findings open the door to developing treatments that consider how men and women respond differently to brain inflammation,” said Dr. Kiruthika Ganesan, the study’s lead author.

What’s Next?

The researchers are calling for more studies to understand:

  • How hormones influence these sex-specific effects.
  • The long-term impact of neuroinflammation on brain health.

For now, the study serves as a reminder of how critical it is to consider sex-specific differences in developing therapies for MS and other neurological conditions.

By tailoring treatments to these differences, there’s potential to not only reduce symptoms but also improve overall quality of life for people with MS.

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Posted on Multiple Sclerosis

How Do MS Drugs Affect Pregnancy?

New guidelines for pregnancy in multiple sclerosis
Pregnancy can be a complex journey for women with multiple sclerosis (MS), especially when considering the impact of disease-modifying therapies (DMTs). A groundbreaking study from Ruhr-University Bochum offers one of the largest datasets yet to understand the effects of these medications during pregnancy.
What the Study Looked At

The study analyzed 2,885 pregnancies from the German Multiple Sclerosis and Pregnancy Registry, spanning data collected between 2006 and 2023. It examined women exposed to a variety of DMTs, including:
Interferons
Glatiramer acetate
Dimethyl fumarate
Teriflunomide
S1P modulators (like fingolimod and ponesimod)
Alemtuzumab
Natalizumab
Anti-CD20 antibodies (rituximab, ocrelizumab, ofatumumab)
Cladribine
For comparison, the study also included 837 women with MS who didn’t take any MS medication during pregnancy.

Key Findings
No Major Increase in Pregnancy Risks
Most DMTs did not significantly increase the risk of complications like spontaneous abortions, premature births, or major birth defects.
However, the data for medications like cladribine, teriflunomide, and alemtuzumab was limited, making it harder to draw firm conclusions about rare complications, such as severe infections or birth defects.
Low Birth Weight Was a Concern
Babies born to mothers with MS—whether or not they took DMTs—were more likely to have a lower-than-average birth weight.
18.8% of babies in the study had low birth weight compared to 10% nationally in Germany.
The risk was highest with S1P modulators (27.4%) and anti-CD20 antibodies (24.1%).
Low birth weight is a concern because it can lead to complications, including neonatal death and long-term health risks like type 2 diabetes and cardiovascular disease.
Infections Were Rare but Monitored
Serious infections were infrequent, but:
Fumarate (2.8%) and alemtuzumab (9.1%) were linked to more infections during pregnancy.
Severe infections were slightly higher in cases treated with natalizumab in late pregnancy (3%) or S1P modulators (3%).
Anti-CD20 therapies, surprisingly, were associated with a lower rate of severe infections (0.6%) than expected.
Women exposed to natalizumab or anti-CD20 antibodies were more likely to need antibiotics during pregnancy.
What Does This Mean for Pregnant Women with MS?
While the findings are reassuring overall, they underscore the importance of an individual risk-benefit assessment when deciding whether to continue MS medications during pregnancy.
Monitoring is Key: Pregnant women with MS should work closely with their healthcare providers to ensure their treatment plan balances managing their MS symptoms with minimizing potential risks to the baby.
More Research Needed: The registry will continue tracking outcomes to see if babies with low birth weight eventually catch up in growth.
Conclusion
The study offers valuable insights into how MS medications interact with pregnancy. While most DMTs don’t pose a significant risk, some may influence birth weight or infection risk, emphasizing the need for personalized care and close medical supervision.


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