A Systematic Review of Stress-Management Interventions for Multiple Sclerosis Patients

Background: The objective of this study was to identify stress-management interventions used for people with multiple sclerosis (MS) and systematically evaluate the efficacy of these interventions. Methods: Several strategies were used to search for studies reported in articles published up to 2013. Results: Our initial search retrieved 117 publications, of which 8 met our criteria for review. Of the eight studies, one provided Class I evidence, five provided Class III evidence, and two provided Class IV evidence for the efficacy of stress-management interventions according to the evidence classification established by the American Academy of Neurology. Most studies showed positive changes in outcomes assessed; however, the range of methodological quality among the published studies made it difficult to draw conclusions. Conclusions: The promising findings for stress-management interventions highlight the need for future studies. Additional large, prospective, multicenter studies will help to define the role of stress-management interventions in the treatment and course of MS. Furthermore, including outcome measures based on biological and clinical markers of disease will prove useful in understanding potential underlying mechanisms.

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NRAMP1 Polymorphism and Viral Factors in Sardinian Multiple Sclerosis Patients

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100009173 ◽

2008 ◽

Vol 35 (4) ◽

pp. 491-494 ◽

Cited By ~ 12

Author(s):

Maria Gazouli ◽

Leonardo Sechi ◽

Daniela Paccagnini ◽

Stefano Sotgiu ◽

Giannina Arru ◽

...

Keyword(s):

Multiple Sclerosis ◽

Autoimmune Disease ◽

Promoter Region ◽

Viral Infections ◽

Jc Virus ◽

Allelic Variation ◽

Sardinian Population ◽

Multiple Sclerosis Patients ◽

Viral Sequences

Background:Multiple sclerosis (MS) is believed to be an autoimmune disease occurring in genetically predisposed individuals after an appropriate environmental exposure such as viral infections. Recent studies suggest a significant association between MS and the functional 5’-(GT)n polymorphism in the promoter region of the NRAMP1 gene. In the present study we aimed to evaluate the contribution of the allelic variation in the NRAMP1 promoter to MS susceptibility and to study the role of viral infection in relation to specific NRAMP1 genotypes, in a Sardinian cohort.Methods:Sixty MS patients and 66 healthy individuals were genotyped, and screened for the presence of Epstein-bar virus (EBV) and JC virus (JCV) sequences.Results:Consistent with previous autoimmune disease studies, allele 3 at the functional 5’(GT)n promoter region repeat polymorphism, was significantly overrepresented among MS patients when compared to controls (p=0.02). The EBV and JCV sequences were detected in 8/60 (13.33%) and in 4/60 (6.66%) of MS patients respectively and in 5/66 (7.57%) and in 0/66 of controls.Conclusion:The allelic variation in the NRAMP1 promoter may contribute to MS susceptibility in the Sardinian population. The viral sequences were not confined to a specific NRAMP1 genotype.

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The Role of the Primary-Care Physician in Treating Relapses in Multiple Sclerosis Patients

International Journal of MS Care ◽

10.7224/1537-2073-11.3.122 ◽

2009 ◽

Vol 11 (3) ◽

pp. 122-126 ◽

Cited By ~ 1

Author(s):

Sarah A. Morrow ◽

Marcelo Kremenchutzky

Keyword(s):

Multiple Sclerosis ◽

Primary Care ◽

Primary Care Physicians ◽

Tertiary Care ◽

Care Physician ◽

Diagnosis And Treatment ◽

High Prevalence ◽

Tertiary Care Centers ◽

Multiple Sclerosis Patients

Multiple sclerosis (MS) is a common disabling neurologic disease with an overall prevalence in Canada of 240 in 100,000. Multiple sclerosis clinics are located at tertiary-care centers that may be difficult for a patient to access during an acute relapse. Many relapses are evaluated by primary-care physicians in private clinics or emergency departments, but these physicians' familiarity with MS is not known. Therefore, a survey was undertaken to determine the knowledge and experience of primary-care physicians regarding the diagnosis and treatment of MS relapses. A total of 1282 licensed primary-care physicians in the catchment area of the London (Ontario, Canada) Multiple Sclerosis Clinic were identified and mailed a two-page anonymous survey. A total of 237 (18.5%) responses were obtained, but only 216 (16.8%) of these respondents were still in active practice. Of these 216 physicians, only 9% reported having no MS patients in their practice, while 70% had one to five patients, 16.7% had six to ten, and 1.9% had more than ten (3.7% did not respond to this question). Corticosteroids were recognized as an MS treatment by 49.5% of the respondents, but only 43.1% identified them as a treatment for acute relapses. In addition, 31% did not know how to diagnose a relapse, and only 37% identified new signs or symptoms of neurologic dysfunction as indicating a potential relapse. Despite the high prevalence of MS in Canada, primary-care physicians require more education and support from specialists in MS care regarding the diagnosis and treatment of MS relapses.

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Multiple sclerosis patients and immunomodulation therapies: the potential role of new MRI techniques to assess responders versus non-responders

Neurological Sciences ◽

10.1007/s10072-005-0516-4 ◽

2005 ◽

Vol 26 (S4) ◽

pp. s209-s212 ◽

Cited By ~ 4

Author(s):

G. Tedeschi ◽

A. Gallo

Keyword(s):

Multiple Sclerosis ◽

Potential Role ◽

Multiple Sclerosis Patients

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PATHOGENIC ROLE OF AUTONOMIC DYSFUNCTION IN COLD INTOLERANCE IN MULTIPLE SCLEROSIS PATIENTS

Pathophysiology ◽

10.1016/j.pathophys.2018.07.084 ◽

2018 ◽

Vol 25 (3) ◽

pp. 196

Author(s):

Liudmila Gerasimova-Meigal ◽

Ilya Sirenev

Keyword(s):

Multiple Sclerosis ◽

Autonomic Dysfunction ◽

Pathogenic Role ◽

Cold Intolerance ◽

Multiple Sclerosis Patients

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The relation between objective and subjective impairment in cognitive function among multiple sclerosis patients – the role of depression

Multiple Sclerosis Journal ◽

10.1191/135245801678227658 ◽

2001 ◽

Vol 7 (2) ◽

pp. 131-135 ◽

Cited By ~ 2

Author(s):

Y. Maor ◽

L. Olmer ◽

B. Mozes

Keyword(s):

Multiple Sclerosis ◽

Cognitive Function ◽

Multiple Sclerosis Patients

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Neuropsychological impairment in multiple sclerosis patients: the role of (juxta)cortical lesion on FLAIR

Multiple Sclerosis Journal ◽

10.1191/135245800678827824 ◽

2000 ◽

Vol 6 (4) ◽

pp. 280-285 ◽

Cited By ~ 6

Author(s):

R.H.C. Lazeron ◽

D.W. Langdon ◽

M. Filippi ◽

J.H.T.M. van Waesberghe ◽

V.L. Stevenson ◽

...

Keyword(s):

Multiple Sclerosis ◽

Neuropsychological Impairment ◽

Cortical Lesion ◽

Multiple Sclerosis Patients

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Depression symptoms in multiple sclerosis patients – The role of IL1B

Journal of the Neurological Sciences ◽

10.1016/j.jns.2017.08.691 ◽

2017 ◽

Vol 381 ◽

pp. 242 ◽

Cited By ~ 1

Author(s):

A. Bettencourt ◽

B. Leal ◽

M. Ferreira ◽

C. Carvalho ◽

I. Moreira ◽

...

Keyword(s):

Multiple Sclerosis ◽

Depression Symptoms ◽

Multiple Sclerosis Patients

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Venous Thrombosis in Multiple Sclerosis Patients after High-Dose Intravenous Methylprednisolone: The Preventive Effect of Enoxaparin

Thrombosis ◽

10.1155/2011/785459 ◽

2011 ◽

Vol 2011 ◽

pp. 1-4 ◽

Cited By ~ 9

Author(s):

Hossein Kalanie ◽

Ali Amini Harandi ◽

Shapoor Alidaei ◽

Daryoosh Heidari ◽

Saeed Shahbeigi ◽

...

Keyword(s):

Multiple Sclerosis ◽

Venous Thrombosis ◽

High Dose ◽

Intravenous Methylprednisolone ◽

Relapsing Remitting ◽

Acute Attacks ◽

Multiple Sclerosis Patients ◽

Relapsing Remitting Multiple Sclerosis ◽

Preventive Role

Aim. This study was designed to examine the possible role of high-dose intravenous methylprednisolone (IVMP) in the development of venous thrombosis (VT). The cerebral one anecdotally had been reported in patients with relapsing remitting multiple sclerosis (RRMS) in acute attacks and the possible preventive role of enoxaparin. Material and Methods. From a pool of 520 patients, 388 patients with definite RRMS who fulfilled entry characteristics were selected and randomly received either a 5-day course of daily 1 gr IVMP or the aforementioned plus 5 days of daily subcutaneous 40 units of enoxaparin according to a predefined protocol. Results. Mean age, gender ratio, mean relapse rate, and EDSS were similar in both groups of patients (P > 0.05). Finally, 366 patients remained in the study. Of 188 patients treated with IVMP with 855 relapses, 5 developed VT (0.37% per patient per year and 0.58% per each course of IVMP) within 3 to 15 days of starting therapy. None of the 178 patients who experienced 809 relapses who received IVMP plus enoxaparin developed such complications. Conclusion. The study implies that high-dose IVMP in MS exacerbation may increase the risk of VT and prophylactic anticoagulant treatment in this setting is warranted.

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