Posted on Fatigue, Multiple Sclerosis

“Measuring and treating fatigue in multiple sclerosis: Current challenges evaluated.”

New study sheds light on defining, assessing, and addressing MS-related fatigue
A recent study provides insights into how to define, assess, and address fatigue related to multiple sclerosis (MS).

Kessler Foundation research scientist John DeLuca, PhD, has recently published a crucial clinical article in the Journal of Neurology. The article sheds light on the elusive nature of fatigue in multiple sclerosis (MS) and its implications for treatment. The study provides a comprehensive review of current challenges in defining, measuring, and treating MS-related fatigue, offering new insights and directions for future research.

It sheds light on the complex nature of fatigue in multiple sclerosis, underscoring the challenges in accurately defining and effectively measuring it. Dr. DeLuca found more than 250 scales used to assess fatigue but noticed significant content validity issues, which raised concerns about their reliability.

“Ou” ability to define, measure, and treat fatigue in MS has only marginally improved despite over a century of research,”” said Dr. DeLuca, senior vice president for research and training at the Foundation. “The study underscores the need for innovative approaches to understand better and address this complex symptom. It also highlights distinguishing fatigue from other related symptoms and developing more precise measurement tools. Addressing these challenges is crucial for improving the quality of life for individuals with MS.”

F”tigue affects up to 90 per cent of individuals with MS, significantly impacting their daily lives. Despite its prevalence, defining fatigue remains challenging due to its subjective and multifaceted nature. The article reviews historical and contemporary definitions of fatigue, critiques existing measurement tools for their lack of clarity and consistency, and explores the subjective nature of fatigue and its correlation with other symptoms such as depression, pain, and cognitive complaints.

Furthermore, Dr. DeLuca examines the brabrain’sle in fatigue, proposing that disruptions in the cortico-striato-thalamo-cortical loop contribute to central fatigue. “Ad”anced MRI imaging techniques have shown that central fatigue correlates with disruptions in this brain network. Recent research indicates that motivational incentives can reduce fatigue by stimulating the frontostriatal network, suggesting new potential treatment approaches,” h” emphasized.

How Can We Treat Fatigue?
The study discusses pharmacological and non-pharmacological treatments for fatigue in MS. Pharmacological treatments, such as amantadine, modafinil, and methylphenidate, have shown limited effectiveness. In contrast, the article also explores non-pharmacological treatments for fatigue, such as cognitive-behavioral therapy and exercise, which have demonstrated moderate to significant effects in reducing fatigue symptoms. The potential of novel approaches involving the brabrain’sward system is also mentioned, suggesting that motivational incentives could play a crucial role in managing fatigue in MS patients.

Posted on Diabetes, Diet, Exercise

Type 2 diabetes can be prevented through diet and exercise, even in individuals with a high genetic risk.

Exercise more effective than medicines to manage mental health

The University of Eastern Finland conducted a groundbreaking study which demonstrates that maintaining a healthy diet and engaging in regular exercise can decrease the likelihood of developing type 2 diabetes, even in individuals with a high genetic risk. This means that lifestyle changes, such as diet and exercise, can benefit everyone, regardless of their genetic predisposition.

Type 2 diabetes is a major global issue. The International Diabetes Federation (IDF) reports that one in eleven adults worldwide has diabetes, and 90 per cent of these cases are type 2 diabetes. Researchers have discovered over 500 genetic variants that can make individuals more likely to develop type 2 diabetes. However, lifestyle factors such as being overweight, consuming low dietary fibre, high intake of saturated fats, and lack of exercise also play a significant role in the risk of developing the disease. Previous studies have demonstrated that lifestyle changes can effectively prevent type 2 diabetes. However, it’s not yet known whether the disease can be prevented in individuals carrying multiple genetic variants that predispose them to type 2 diabetes.

The T2D-GENE Trial was a three-year lifestyle intervention that involved nearly 1,000 men aged 50 to 75 in eastern Finland. All participants had elevated fasting glucose at the beginning of the study. More than 600 men received guidance on health-promoting lifestyles and were part of the intervention group, while the rest served as a control group. The intervention group received support through group meetings and a dedicated web portal. Participants were divided into two groups based on their genetic risk of developing type 2 diabetes, determined by assessing 76 gene variants. Neither the participants nor the researchers knew to which genetic risk group the participants belonged. All participants in the intervention group received the same lifestyle guidance.

Men who took part in the lifestyle intervention showed significant improvement in their diet quality. They increased their intake of dietary fibre, improved the quality of fats they consumed, and ate more vegetables, fruits, and berries. Although the study was not specifically focused on weight loss, the participants did experience weight loss. At the beginning of the study, the participants were already very physically active and they were able to maintain their exercise habits. These changes led to a reduction in the decline of glucose metabolism. The lifestyle intervention group had a significantly lower prevalence of type 2 diabetes compared to the control group. Importantly, the positive effects of the lifestyle changes were observed across individuals, regardless of whether they had a low or high genetic risk.

“These findings encourage everyone to make lifestyle changes that promote health. Furthermore, they demonstrate the effectiveness of group- and internet-based lifestyle guidance, which saves healthcare resources,” says University Lecturer, Docent Maria Lankinen

Posted on Autism

A new study has confirmed that there are high rates of autism recurrence in families with autistic children.

Using more comprehensive reporting strategies than in the past, researchers find significantly elevated autism risk among younger siblings
Using more comprehensive reporting strategies than in the past, researchers found significantly elevated autism risk among younger siblings.

A study conducted by top researchers, including those from the Kennedy Krieger Institute, has revealed that one in five children (20%) with an older sibling diagnosed with autism are also likely to be diagnosed with the disorder. The data shows that when a child has more than one older sibling with autism, the family recurrence rate rises to over 36%.

This study analyzed data from 1,605 infants who had an older sibling with autism. The infants were evaluated multiple times from 6 months to 36 months. The research, conducted by organizations such as the Baby Siblings Research Consortium and the Kennedy Krieger Institute, found that the risk of autism recurrence is seven times higher in families with an autistic child compared to the general population. This result is consistent with previous research, but the investigators noted that this new study employed more comprehensive reporting methods.

Dr. Rebecca Landa, PhD, CCC-SLP, serves as the Vice President and Executive Director for the Center for Autism Services, Science, and Innovation (CASSI) at Kennedy Krieger. She was involved in this research and says the findings demonstrate the importance of additional developmental monitoring for babies born into families with autistic children.

“Pediatricians and family members need to diligently monitor infants born into families with a diagnosed autistic child,” Dr. Landa emphasized. “Early referral for diagnostic evaluation is crucial to ensure support, resources, and intervention.”

The research discovered that the gender of a child has a significant impact on the likelihood of autism recurrence. It was found that younger siblings of female autistic children had a greater tendency to develop autism (34.7%) compared to siblings of males (22.5%). Moreover, male younger siblings were also more likely to be autistic than their female counterparts.

Additionally, the study found that the recurrence of autism in white families was 17.8%, while it increased to 25% across other races combined.

“The scale and diversity of this group of infants, compared to our previous recurrence rate study published over a decade ago, provides strong evidence that these recurrence rates are reliable,” said Dr. Landa. “We need to update recurrence studies like these due to the population increase in autism prevalence over the years. We know so much more now in 2024 than we did in 2011.”

The study found that maternal education has a significant effect on autism recurrence rates. Mothers with a high school education or less had a higher recurrence rate of 32.6%, which decreased for mothers with a college or graduate degree. This effect was only significant for mothers and not for fathers.

Researchers say the prevalence of autism has risen to 1 in 36 children over the last decade. They attribute this increase to improved awareness of autistic females and cognitively able/verbal children rather than a true rise in autism rates.

Dr. Landa points out that the study’s findings show how race, sex, education, and access to healthcare can affect the timing of diagnoses and support. She stresses the importance of making better efforts to address disparities as we gain more knowledge about autism.

“It’s essential to ensure that families facing social inequities have access to resources, education, and providers,” said Dr. Landa. “Every child with autism and their family deserves this support.”

Posted on Fibromyalgia

“Can cannabis effectively treat fibromyalgia pain?”

A lot of individuals suffering from fibromyalgia have shared that cannabis, also known as medical marijuana, provides relief for their pain. However, there hasn’t been enough research to support this claim until recently. In the video, I’ll discuss how cannabis works in the body to alleviate pain, and I’ll also delve into recent studies that explore the effectiveness of cannabis in reducing fibromyalgia pain.

Posted on Diabetes

CT health screening can identify diabetes risk

The findings highlight the importance of analyzing the impact of life stressors on those with MS

A study published today in Radiology, a journal of the Radiological Society of North America (RSNA), found that analyzing CT scans in people undergoing health screening can help identify individuals at risk of type 2 diabetes. The findings highlight the value of CT scans in opportunistic imaging, which involves using information from routine imaging examinations to gain insights into a patient’s overall health.

For the new study, researchers assessed the capability of automated CT-derived markers in predicting diabetes and related conditions.

“We aimed to explore whether automated and precise imaging analyses could enhance early detection and risk stratification beyond conventional methods, given the significant burden of diabetes and its complications,” said study senior author Seungho Ryu, M.D., Ph.D., from the Kangbuk Samsung Hospital at Sungkyunkwan University School of Medicine in Seoul, South Korea.

Dr. Ryu and his colleagues utilized clinically validated deep learning algorithms to analyze the CT images, enabling 3D segmentation and quantification of various body components such as visceral fat, subcutaneous fat, muscle mass, liver density, and aortic calcium.

Diabetes prevalence stood at 6% at the beginning, and the incidence rose to 9% over a median follow-up of 7.3 years.

Through automated multiorgan CT analysis, individuals at high risk of diabetes and associated conditions were identified. The index of visceral fat, which is the belly fat under the muscles and around the organs of the abdomen, showed the highest predictive performance for diabetes. Combining visceral fat, muscle area, liver fat fraction, and aortic calcification improved predictive performance. CT-derived markers also identified ultrasound-diagnosed fatty liver, coronary artery calcium scores of more than 100, osteoporosis, and age-related muscle loss called sarcopenia.

“These markers were more effective than traditional risk factors in predicting type 2 diabetes.”

“The results are encouraging as they demonstrate the potential of expanding the role of CT imaging from conventional disease diagnosis to opportunistic proactive screening,” Dr. Ryu said. “This automated CT analysis improves risk prediction and early intervention strategies for diabetes and related health issues.”

Dr. Ryu noted that these CT-derived markers have the potential to enhance the traditional approach to diabetes screening and risk assessment in the clinical setting.

“By incorporating these advanced imaging techniques into opportunistic health screenings, clinicians can more accurately and promptly identify individuals at high risk for diabetes and its complications compared to the current approach,” he said. “This may result in more personalized and timely interventions, ultimately enhancing patient outcomes.”