scholarly journals What Are the Participants’ Perspectives of Taking Melatonin for the Treatment of Nocturia in Multiple Sclerosis? A Qualitative Study Embedded within a Double-Blind RCT

2018 ◽  
Vol 2018 ◽  
pp. 1-9
Author(s):  
Rafiyah Khan ◽  
Alan Uren ◽  
Luke Canham ◽  
David Cottrell ◽  
Marcus J. Drake ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Trial ◽  
Psychological Functioning ◽  
Qualitative Interviews ◽  
Negative Effects ◽  
Double Blind ◽  
Trial Treatment ◽  
The Central Nervous System ◽  
Qualitative Exploration ◽  
The Impact

Background. Multiple Sclerosis (MS) is a chronic neurological disorder caused by neurodegeneration within the central nervous system. It results in impaired physical, cognitive, and psychological functioning and can also lead to lower urinary tract symptoms including nocturia. While clinical trials have suggested an association between nocturia and melatonin secretion, to our knowledge, no qualitative research has been conducted on the experience of taking melatonin to treat nocturia in progressive MS within a clinical trial. Methods. 17 semistructured qualitative interviews were conducted as part of a double-blind, randomised, placebo controlled, crossover, clinical trial with consenting adults with MS. Interviews explored participants’ experiences of nocturia associated with MS and their experience of taking melatonin as a trial treatment for nocturia versus a placebo. Data was analysed using a thematic analysis. Results. Themes on the experience of nocturia revealed participants’ understandings of nocturia, the impact it had on their night, and increased daily fatigue. Themes on the intervention showed perceived improvements to nocturia, sleep, and energy and negative effects including lethargy, a lack of significant change, and physical side effects including vivid dreams. Conclusion. This qualitative exploration revealed an association between nocturia and increased levels of fatigue during the day by those with MS. However, perspectives towards the effectiveness of melatonin as a potential treatment varied as both placebo and melatonin were perceived as having very similar effects.

The Effects of Different Kinds of Nutrition and Functional Foods on Multiple Sclerosis

2020 ◽  
Vol 16 (5) ◽  
pp. 632-637
Author(s):  
Masih Falahatian
Keyword(s):  
Multiple Sclerosis ◽  
Functional Foods ◽  
Fruits And Vegetables ◽  
Salt Intake ◽  
Vegetable Intake ◽  
Dietary Salt ◽  
Negative Effects ◽  
Dietary Salt Intake ◽  
Neuroinflammatory Disease ◽  
The Central Nervous System

It is an assumption that different kinds of nutrition, diet, and functional foods might have different positive or negative effects on multiple sclerosis (MS), a neuroinflammatory disease of the central nervous system (CNS). This brief paper involved a study on various kinds of nutrition including salt, fat, dairy, fruit, and vegetables. At the end of this study, appropriate diets were evaluated for MS patients. Based on previous studies both on animal models and on MS patients, excessive dietary salt intake and animal fat had worsening effects on MS patients but fruit and vegetable intake helped the remission of MS and decreased the risk of developing it. There were, of course, conflicting results in different studies over the role of some nutrition in MS and future studies on larger numbers of cases were required to collect reliable results. As a result, at the end of this study and based on literature, it is suggested that a diet should be programmed by nutritionists containing fewer salt, fat, and dairy intake and more fruits and vegetables for MS patients in order to better management of the disease.

scholarly journals Publisher Correction to: BRAINSTORMING: A study protocol for a randomised double-blind clinical trial to assess the impact of concurrent brain stimulation (tDCS) and working memory training on cognitive performance in Acquired Brain Injury (ABI)

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Sara Assecondi ◽  
Rong Hu ◽  
Gail Eskes ◽  
Michelle Read ◽  
Chris Griffiths ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Working Memory ◽  
Brain Injury ◽  
Cognitive Performance ◽  
Acquired Brain Injury ◽  
Working Memory Training ◽  
Memory Training ◽  
Double Blind ◽  
Double Blind Clinical Trial ◽  
The Impact

Following publication of the original article [1], the authors flagged that the article had published with the Acknowledgements erroneously excluded from the declarations at the end of the article.

scholarly journals Responsiveness of the Scripps Neurologic Rating Scale During a Multiple Sclerosis Clinical Trial

1999 ◽  
Vol 26 (4) ◽  
pp. 283-289 ◽  
Author(s):  
James A. Koziol ◽  
Adriana Lucero ◽  
Jack C. Sipe ◽  
John S. Romine ◽  
Ernest Beutler
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Trial ◽  
Rating Scale ◽  
Effect Sizes ◽  
Active Therapy ◽  
Double Blind ◽  
Treatment Groups ◽  
Negative Effect ◽  
The Individual ◽  
Positive Effect

Objective:The Scripps neurologic rating scale (SNRS) is a summary measure of individual components comprising a neurological examination, designed for use in multiple sclerosis (MS). Our objective is to evaluate the responsiveness of the SNRS, within the context of a 2-year, randomized, double-blind crossover study of the efficacy of cladribine for treatment of secondary progressive MS.Methods:Effect sizes were determined for the SNRS and its components, separately for each treatment group (initial placebo, and initial cladribine) over both years of the clinical trial, using a standard random effects model.Results:Individual components tended to show positive effect sizes (improvement) during periods of active therapy in both treatment groups, and negative effect sizes (deterioration) during periods of no active therapy. Summation indices derived from the individual components of the SNRS seemed somewhat more stable than the individual components. The two components mentation and mood, and bladder, bowel, or sexual dysfunction, were rather unresponsive in our clinical trial.Conclusion:Changes in the components of the SNRS over the course of our clinical trial were consistent between the two treatment groups. Most components were moderately responsive; and, the summary SNRS score appropriately summarized the moderate magnitudes of change evinced in the individual components.

scholarly journals Preventive Effect of Liothyronine on Electroconvulsive Therapy-Induced Memory Deficit in Patients with Major Depressive Disorder: A Double-Blind Controlled Clinical Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Arash Mohagheghi ◽  
Asghar Arfaie ◽  
Shahrokh Amiri ◽  
Masoud Nouri ◽  
Salman Abdi ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Electroconvulsive Therapy ◽  
Visual Memory ◽  
Memory Deficit ◽  
Control Group ◽  
Major Depressive ◽  
Double Blind ◽  
The Impact

Introduction and Objective. Despite the effectiveness of electroconvulsive therapy (ECT) in treating major depressive disorder (MDD), its cognitive side effects make it less popular. This study investigated the impact of liothyronine on ECT-induced memory deficit in patients with MDD.Methodology. This is a double-blind clinical trial, in which 60 patients with MDD who were referred for ECT were selected. The diagnosis was based on the criteria of DSM-IV-TR. Patients were divided randomly into two groups to receive either liothyronine (50 mcg every morning) or placebo. After the assessment with Wechsler Memory Scale-Revised (WMS-R) before first session of ECT, posttests were repeated again, two months after the completion of ECT.Findings. By controlling the pretest scores, the mean scores of the experimental group were higher than the control group in delayed recall, verbal memory, visual memory, general memory, and attention/concentration scales (P<0.05).Conclusion. Liothyronine may prevent ECT-induced memory impairment in patients with MDD. This study has been registered in IRCT underIRCT201401122660N2.

scholarly journals Validation and cross-cultural adaptation of sexual dysfunction modified scale in multiple sclerosis for Brazilian population

2015 ◽  
Vol 73 (8) ◽  
pp. 681-687 ◽  
Author(s):  
Raquel Ataíde Peres da Silva ◽  
Guilherme Sciascia do Olival ◽  
Lívia Palma Stievano ◽  
Vania Balardin Toller ◽  
Sergio Semeraro Jordy ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Sexual Dysfunction ◽  
Cultural Adaptation ◽  
Chronic Inflammatory Disease ◽  
Cross Cultural ◽  
Brazilian Population ◽  
Control Group ◽  
Cross Cultural Adaptation ◽  
The Central Nervous System ◽  
The Impact

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS). These patients suffer from various comorbidities, including sexual dysfunction (SD). The lesions of MS may affect regions of the CNS along the pathway of sexual response. The Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19) is a scale that assesses sexual dysfunction. Adapt and validate the MSISQ-19 to Brazilian patients with MS. 204 individuals were evaluated, 134 patients with MS and 70 healthy persons for the control group. It was determined reproducibility, validity, internal consistency and sensitivity of the MSISQ-19-BR. Among patients with MS, 54.3% of male and 71.7% of female presented some kind of SD. In the control group the results were 12.5% and 19.5%, respectively. The MSISQ-19-BR is reproducible, reliable and valid for the Brazilian population and may be used as a tool for assessing the impact of sexual dysfunction in patients with MS.

The impact of hypoxia on blood-brain, blood-CSF and CSF-brain barriers

2021 ◽  
Author(s):  
Jeff F. Dunn ◽  
Albert M Isaacs
Keyword(s):  
Multiple Sclerosis ◽  
Cerebrospinal Fluid ◽  
Cellular Structures ◽  
Bacterial Toxin ◽  
Blood Brain ◽  
High Altitude Cerebral Edema ◽  
The Central Nervous System ◽  
Neurological Conditions ◽  
The Impact ◽  
Brain Barriers

The blood-brain barrier (BBB), blood-cerebrospinal fluid barrier (BCSFB) and CSF-brain barriers (CSFBB) are highly regulated barriers in the central nervous system comprising of complex multi-cellular structures that separate nerves and glia from blood and cerebrospinal fluid, respectively. Barrier damage has been implicated in the pathophysiology of diverse hypoxia-related neurological conditions including stroke, multiple sclerosis, hydrocephalus and high-altitude cerebral edema. Much is known about damage to the BBB in response to hypoxia but much less is known about the BCSFB and CSFBB. Yet it is known that these other barriers are implicated in damage after hypoxia or inflammation. In the 1950s, it was shown that the rate of radionucleated human serum albumin passage from plasma to CSF was 5-times higher during hypoxic than normoxic conditions in dogs, due to blood-CSF barrier disruption. Severe hypoxia due to administration of the bacterial toxin, lipopolysaccharide (LPS) is associated with disruption of the CSFBB. This review discusses the anatomy of the BBB, BCSFB and CSFBB, and the impact of hypoxia and associated inflammation on the regulation of those barriers.

scholarly journals A randomised double-blind placebo-controlled feasibility trial of flavonoid-rich cocoa for fatigue in people with relapsing and remitting multiple sclerosis

2019 ◽  
Vol 90 (5) ◽  
pp. 507-513 ◽  
Author(s):  
Shelly Coe ◽  
Jo Cossington ◽  
Johnny Collett ◽  
Andrew Soundy ◽  
Hooshang Izadi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Potential Effect ◽  
Feasibility Trial ◽  
Walk Test ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Moderate Effect ◽  
Remitting Multiple Sclerosis ◽  
The Impact ◽  
Improve Fatigue

The impact of flavonoids on fatigue has not been investigated in relapsing and remitting multiple sclerosis (RRMS).ObjectiveTo determine the feasibility and estimate the potential effect of flavonoid-rich cocoa on fatigue and fatigability in RRMS.MethodsA randomised double-blind placebo-controlled feasibility study in people recently diagnosed with RRMS and fatigue, throughout the Thames Valley, UK (ISRCTN69897291). During a 6-week intervention participants consumed a high or low flavonoid cocoa beverage daily. Fatigue and fatigability were measured at three visits (weeks 0, 3 and 6). Feasibility and fidelity were assessed through recruitment and retention, adherence and a process evaluation.Results40 people with multiple sclerosis (10 men, 30 women, age 44±10 years) were randomised and allocated to high (n=19) or low (n=21) flavonoid groups and included in analysis. Missing data were <20% and adherence to intervention of allocated individuals was >75%. There was a small effect on fatigue (Neuro-QoL: effect size (ES) 0.04, 95% CI −0.40 to 0.48) and a moderate effect on fatigability (6 min walk test: ES 0.45, 95% CI −0.18 to 1.07). There were seven adverse events (four control, three intervention), only one of which was possibly related and it was resolved.ConclusionA flavonoid beverage demonstrates the potential to improve fatigue and fatigability in RRMS.

scholarly journals Potential Impact of B Cells on T Cell Function in Multiple Sclerosis

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Sara Ireland ◽  
Nancy Monson
Keyword(s):  
Multiple Sclerosis ◽  
T Cells ◽  
T Cell ◽  
B Cells ◽  
Cell Function ◽  
The Central Nervous System ◽  
Potential Impact ◽  
Anti Cd20 ◽  
The Impact ◽  
Ms Pathogenesis

Multiple sclerosis is a chronic debilitating autoimmune disease of the central nervous system. The contribution of B cells in the pathoetiology of MS has recently been highlighted by the emergence of rituximab, an anti-CD20 monoclonal antibody that specifically depletes B cells, as a potent immunomodulatory therapy for the treatment of MS. However, a clearer understanding of the impact B cells have on the neuro-inflammatory component of MS pathogenesis is needed in order to develop novel therapeutics whose affects on B cells would be beneficial and not harmful. Since T cells are known mediators of the pathology of MS, the goal of this review is to summarize what is known about the interactions between B cells and T cells, and how current and emerging immunotherapies may impact B-T cell interactions in MS.

What do we currently know about the clinically isolated syndrome suggestive of multiple sclerosis? An update

2020 ◽  
Vol 31 (3) ◽  
pp. 335-349
Author(s):  
Tomasz Grzegorski ◽  
Jacek Losy
Keyword(s):  
Multiple Sclerosis ◽  
Predictive Factors ◽  
Clinically Isolated Syndrome ◽  
Clinical Image ◽  
Double Blind ◽  
Beneficial Effects ◽  
Mcdonald Criteria ◽  
Clinical Episode ◽  
The Central Nervous System ◽  
Large Groups

AbstractMultiple sclerosis (MS) is a chronic, demyelinating, not fully understood disease of the central nervous system. The first demyelinating clinical episode is called clinically isolated syndrome (CIS) suggestive of MS. Although the most common manifestations of CIS are long tracts dysfunction and unilateral optic neuritis, it can also include isolated brainstem syndromes, cerebellar involvement, and polysymptomatic clinical image. Recently, the frequency of CIS diagnosis has decreased due to the more sensitive and less specific 2017 McDonald criteria compared with the revisions from 2010. Not all patients with CIS develop MS. The risk of conversion can be estimated based on many predictive factors including epidemiological, ethnical, clinical, biochemical, radiological, immunogenetic, and other markers. The management of CIS is nowadays widely discussed among clinicians and neuroscientists. To date, interferons, glatiramer acetate, teriflunomide, cladribine, and some other agents have been evaluated in randomized, placebo-controlled, double-blind studies relying on large groups of patients with the first demyelinating event. All of these drugs were shown to have beneficial effects in patients with CIS and might be used routinely in the future. The goal of this article is to explore the most relevant topics regarding CIS as well as to provide the most recent information in the field. The review presents CIS definition, classification, clinical image, predictive factors, and management. What is more, this is one of very few reviews summarizing the topic in the light of the 2017 McDonald criteria.

scholarly journals A-03 The Brain–Body Connection in Aging Neurological Populations: Examining the Impact of Exercise and Sedentary Behavior on Brain Structure and Cognitive Functioning in Older Adults with Multiple Sclerosis

2020 ◽  
Vol 35 (6) ◽  
pp. 776-776
Author(s):  
C Roman ◽  
P Arnett
Keyword(s):  
Multiple Sclerosis ◽  
Older Adults ◽  
Graph Theory ◽  
Sedentary Behavior ◽  
Healthy Aging ◽  
Moderate Activity ◽  
Subcortical Structures ◽  
Negative Effects ◽  
Age Related ◽  
The Impact

Abstract Objective Advancements in treatments for multiple sclerosis (MS) have led to an increase in the number of older adults living with the disease. Exercise has been shown to be remarkably beneficial for “healthy aging,” while sedentary behavior has proved to have more deleterious effects. Despite evidence for the impact of these factors, their influence on older adults with MS is largely unknown. The current study utilizes volumetric measures and graph theory to investigate the relationship between physical activity/sedentary behavior, structural brain indices, and cognition in older adults with MS. Method Twenty-seven older adults (55+) with MS were scanned during a structural MRI protocol and cognitively evaluated using the Multiple Sclerosis Functional Composite and Symbol Digit Modalities Test. Graph theory metrics were calculated to examine white matter network properties. FreeSurfer was used to calculate volumes for subcortical structures. Exercise was quantified as the ‘days per week engaged in moderate activity,’ while sedentary behavior was measured as ‘hours per day sitting.’ Results Multiple regression interaction analyses were conducted. Results showed an exercise by age interaction, such that exercise protected against the negative effects of age on thalamic volume and assortivity. Hours sitting per day was shown to add to the negative effects of aging on structural networks even after controlling for exercise. Lastly, exercise was observed to be protective against age-related cognitive decline in this sample. Conclusions This is one of the first studies to examine exercise/sedentariness and brain indices in older adults with MS, pointing to possible brain altering and protective interventions for this group.

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