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Foley, Peter Leonard. "Pain in multiple sclerosis." Thesis, University of Edinburgh, 2017. http://hdl.handle.net/1842/28949.
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Background: Pain is frequently reported by people with multiple sclerosis (MS). It has been associated with decreased quality of life, psychiatric morbidity, interference with day to day activities, and frequent healthcare attendance. It has been reported by people with multiple sclerosis to be one of their most important symptoms, and available treatments are limited in their effectiveness. Despite this, our understanding of the epidemiology and mechanisms of pain in people with MS are limited. Our understanding of the interactions of central nervous system mechanisms and pain states overall is growing. However, the application of this knowledge to MS is incomplete. Previous studies have shown that the descending pain modulatory system (DPMS) is an endogenous network of cortical and subcortical brain structures which act to limit, or accentuate, an individual’s perception of pain, via descending brainstem pathways. Associated clinical measures include depression, anxiety, and cognitive flexibility. Our understanding of the function or dysfunction of this system in MS is limited. We do not know if the MS disease process may adversely affect the structure or function of the DPMS. Hypothesis: In people with neuropathic limb pain in relapsing remitting MS (RRMS), compared to people with RRMS who do not have pain, there will be disruption of the endogenous descending pain modulatory system. This will manifest as impaired descending inhibition of pain. Aims and Methods Establishing the background using systematic reviews: The first aim of this thesis was to establish the prevalence, natural history and associations of pain (and pain syndromes) occurring in people with MS. The second aim was to explore existing knowledge of how the MS disease process may contribute to pain states, using a systematic review of neuroimaging studies. Prospective clinical study: A case-control study of 47 people with RRMS was then carried out. 31 of these had neuropathic pain in the limbs, and 16 did not have pain. Using targeted assessments, function of the descending pain modulatory system was assessed in the following ways: First: Detailed clinical, behavioural and neuropsychological assessment, focussing on cognitive, behavioural and affective features known to be closely related to the DPMS. Second: MRI imaging of brain structure, focussing on the volume and location of MS lesions, as well as the volume of key grey-matter structures involved in the DPMS. Third: Resting state functional MRI imaging of the brain, focussing on functional connectivity between the rostral anterior cingulate cortex and two other key DPMS structures (dorsolateral prefrontal cortex, and periaqueductal gray). Results: Systematic reviews: Meta-analysis of existing prospective studies confirmed that pain is very common in MS, affecting about 63% of people with MS on average (95%CI between 55 and 70%). Many different types of pain contribute to this overall estimate. No significant associations with disease course or stage emerged. Several neuroimaging studies have assessed people with MS-associated pain using MRI. These studies were often small, and with associated methodological issues. It is likely that location of MS lesions is implicated in aetiology of pain syndromes in some cases, though our overall knowledge is limited. Prospective study: In a prospective study, people with and without pain were matched for age and gender. Furthermore, groups were balanced for a range of other variables. The pain group more frequently received gabapentinoid medications. The presence of pain was significantly associated with increased scores for depression, fatigue and catastrophising, as well as with specific impairments at neuropsychological assessment, including cognitive flexibility. Many of these impairments are directly relevant to existing models of the DPMS. Overall volume of MS lesions was not different in people with pain, though lesions were more likely to occur in the brainstem. Some alterations of grey-matter volumes in people with pain which mirrored studies of pain disorders outside MS were found, but these did not involve structures key to the DPMS. Affected structures included trigeminothalamic nucleus (relative volume increase in pain group), posterior cingulate cortex and parahippocampal gyrus (volume decrease in pain group). Functional connectivity of the rostral anterior cingulate cortex to the periaqueductal grey matter, a key structure in the descending modulation of pain, was stronger in the group without pain. Conversely, functional connectivity to the dorsolateral prefrontal cortex, repeatedly implicated in the DPMS and thought to be involved in cognitive evaluation and flexibility, was stronger in the pain group. MS lesion volume appeared to account for some of this difference in a multivariate analysis. Limitations: Key limitations of this work include cross-sectional design, small sample size, and number of statistical comparisons carried out. Conclusions: Systematic reviews examined the prevalence, natural history and associations of pain in MS, as well as examining existing neuroimaging studies which investigated how the MS disease process could contribute to pain states. A prospective study found evidence of both emotional/affective and cognitive dysfunctions relevant to the hypothesis of dysfunction in the DPMS. Higher likelihood of MS lesions in the brainstem could be relevant to DPMS function. Separately, there were structural grey-matter volume alterations reflecting those found in many pain studies outside MS. Importantly, however, these did not affect key DPMS structures. Resting state functional MRI however demonstrated altered connectivity of core DPMS structures, which may be partly mediated by MS lesion volume. Functional connectivity findings could be consistent with the hypothesis of impaired descending pain inhibition, in people with relapsing remitting MS affected by neuropathic limb pain.
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Craig, Charles J. "Studies of immunoregulation in Multiple Sclerosis." Thesis, Queen's University Belfast, 1986. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.328088.
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Evangelou, N. "Approaches to defining axonal loss in multiple sclerosis." Thesis, University of Oxford, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.249538.
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Garrison, Jennifer H. "The Effect of an Online Coping Skill Application on Relapsing-Remitting Multiple Sclerosis Sufferers." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/236.
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Many individuals with multiple sclerosis (MS) are classified as having relapsing-remitting MS (RRMS), a form of the illness that requires constant symptom management for suffers to achieve optimum outcomes. There are only a few community-based educational programs that exist to help RRMS sufferers cope with their illness; the effectiveness of those that have been fielded has not yet been adequately assessed. The research questions of this study were to determine if an online training development module would increase the coping skills of those affected by RRMS and if the online educational module would be more effective at improving the coping skills of mild RRMS sufferers versus severe RRMS sufferers. The theoretical foundation was based on a stress-coping model commonly utilized for chronic disease management. The research design employed 2 groups, nonrandom selection, and use of a pretest/posttest applied to the target population from the Georgia MS Chapter. SPSS was used to perform statistical analysis as well as to perform the Mann-Whitney test on study data/results. According to findings from this quantitative study, the application of the online education development module to RRMS sufferers does provide a mechanism of significantly improving their coping skills. This positive social change improvement of coping strategies helps the patients as well as family, friends, and coworkers, and this module would serve as the complement to augment coping strategy improvement efforts for RRMS suffers. This study supports improvement of RRMS sufferer coping skills in the short term, and a future area of research focus would address the long-term improvements in coping skills for RRMS sufferers from the application of this online module.
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Thannhauser, Jennifer, and University of Lethbridge Faculty of Education. "The psychosocial experiences of individuals diagnosed with early-onset MS." Thesis, Lethbridge, Alta. : University of Lethbridge, Faculty of Education, 2005, 2005. http://hdl.handle.net/10133/284.
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This qualitative study explored the psychosocial experiences of children and adolescents with early-onset multiple sclerosis. In particular, an emphasis was placed on examing peer relationships and social behaviours in relation to these experiences. MS is a chronic neurological disease primarily affecting young adults. However, a proportion of MS patients have onset during childhood and adolescence. Very little is know about the psychosocial impact of MS on these children and adolescents. In particular, youth with MS may be at risk for negative peer experiences due to their chronic illness. Previous research suggested that negative peer experiences increase the risk of poor psychosocial development. In addition, research suggested that the social behaviours of these youth also impact the nature of their experiences with peers. Ultimately, this research aimed to provide insight into the psychoscial experiences of youth with MS and the role of their peer relationships. Six linked parent-youth pairs, from the MS Clinic in Calgary, AB, participated in semi-structured interviews to identify the issues that are pertinent to the participants' own experiences. Constant comparison analysis was then used to summarize the rante of psychosocial experiences in the adolescent participants. Data analysis was derived from grounded theory, which provided a framework for examining and categorizing interview data into themes. The categories were then constructed logically and systematically into a theoretical model which represented the data. Through this innovative grounded theory, a theoretical paradigm for understanding the psychosocial experiences of adolescents with MS was developed. The theory was comprised of two core categories: "the grief experience" and "dynamic relationships', each with several sub-categories. There were two primary conclusions drawn from the theory. The first reflected the significance of grief in understanding psychosocial experiences in adolescents with MS. The second identified that peer relationships play a variety of roles in this grief process. The second identified that peer relationships play a variety of roles in this grief process. The results of this study have many implications for the role of counsellors in the treatments of adolescents with MS. This model can act as a foundation for guiding therapeutic treatment of adolescents with MS. This model can act as a foundation for guiding therapeutic treatment and promoting future research in the area of psychosocial development in children and adolescents with early-onset MS.<br>xiv, 181 leaves ; 28 cm.
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Rogers, Stephen. "Glycosylation of immunoglobulin G in cerebrospinal fluid and multiple sclerosis." Thesis, University of Surrey, 2001. http://epubs.surrey.ac.uk/843781/.
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The glycosylation features of CSF oligoclonal IgG, and possible changes in N-glycans of CSF IgG in multiple sclerosis (MS) were studied. After isoelectric focusing (IEF) of CSF, bands were detected using biotinylated lectins and avidin-horseradish peroxidase. Concanavalin A (Con A) binding showed that mannose exists throughout the pH range of oligoclonal IgG. Sambucus nigra antigen (SNA) bound acidic and neutral oligoclonal IgG only, suggesting that alkaline oligoclonal IgG is deficient in sialic acid. Deglycosylation of CSF IgG using peptide-N-glycosidase F suggested that the range of isoelectric points of oligoclonal IgG bands is not due to carbohydrate differences alone. Lectin immunoassays, whereby protein A purified IgG was captured by anti-IgG coated tubes and probed using a range of biotinylated lectins, were used to compare 13 CSF samples from MS patients with 14 control samples. With Con A binding, a significantly higher mean and larger variance was found for the MS group (t-test: P < 0.05). Con A binding correlated with CSF [IgG]/[total protein]% (r=0.390; P=0.0443). Using HPLC to separate oligosaccharides released from IgG by hydrazinolysis and labelled with 2-aminobenzamide, glycans were determined in 7 CSF samples with oligoclonal IgG, and 6 CSF samples without. The ratio of the peak for biantennary fucosylated agalactosyl glycans to total monogalactosylated glycan peaks was lower for the oligoclonal IgG samples (t-test: P=0.0141). The overall results suggested that glycosylation changes occur in CSF IgG in MS, and that oligoclonal IgG contains less sialic acid but more galactose than polyclonal IgG.
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Brown, Nolan J. "Localization of hemoglobin in MS cortex and its relevance to MS neuropathology." Kent State University Honors College / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=ksuhonors1399400834.
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Mann, C. L. A. "The relationship of genetic polymorphisms to disease severity of multiple sclerosis." Thesis, Keele University, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.341244.
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The glutathione S-transferase (GST) supergene family encodes isoenzymes that appear to be critical in protection against oxidative stress. Certain GST loci are polymorphic, demonstrating alleles that are null (GSTMI/GSTT1), encode low activity variants (GSTPI), or are associated with variable inducibility (GSTM3). Interleukin-1 (IL- 1) alpha and beta are cytokines involved in recruitment of inflammatory cells, the process of inflammation, and blood-brain barrier breakdown and nerve regeneration. Polymorphisms of both GST and of a complementary interleukin-1 receptor antagonist have been associated with severity and susceptibility to other inflammatory conditions. This thesis examines the influence of the GST and IL-1 genes on both the susceptibility to Multiple Sclerosis (MS), and the course of disease progression. The population examined consisted of four hundred patients with clinically definite MS. Disease severity was measured using the Kurtzke Expanded Disability Status Scale (EDSS), a robust established ranking scale. PCR-based genotyping was performed using DNA extracted from lymphocytes. Significant associations between genotypes and clinical outcome were corrected for known demographic factors influencing prognosis, these being; gender, onset age, and disease duration using the statistical method of logistic regression. Significant associations, withstanding multiple testing corrections, with certain IL-I genotypes and disease severity were found. There was also a significant trend with the GST isoenzymeM 3 that is expressedin nervous tissue. No robust findings suggest that these genes influence susceptibility to MS, but the results suggest that long-term prognosis is genetically influenced by the modulation of inflammatory cytokines and also by the ability to remove the toxic products of oxidative stress.
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Thummala, Suneel K. "Axon Initial Segment Stability in Multiple Sclerosis." VCU Scholars Compass, 2015. http://scholarscompass.vcu.edu/etd/4038.
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Multiple sclerosis (MS) is an autoimmune disease of the central nervous system characterized by inflammation and demyelination. In addition to these hallmark features, MS also presents with axonal pathology, which is likely responsible for the signs and symptoms of the disease. Although prominent in MS, axonal pathology is frequently considered a consequence of demyelination and not a primary event. This conclusion is consistent with demyelination inducing the loss of specific axonal domains, known as the nodes of Ranvier that are responsible for the propagation of action potentials along the axon. In contrast, we propose that axonal pathology associated with MS is a primary pathological event, independent of demyelination, and not a product of it. In support of our hypothesis, we have analyzed a different axonal domain known as the axon initial segment. Whereas a single axon has numerous nodes of Ranvier uniformly distributed along the axon, each axon contains only a single axon initial segment that is positioned immediately distal to the neuronal cell body. The axon initial segment is responsible for action potential generation and modulation, and hence is essential for normal neuronal function. Background studies conducted by our lab, employing a murine model of demyelination/remyelination, revealed no correlation between axon initial segment stability and myelin integrity. Here we investigate the fate of the axon initial segment in human multiple sclerosis. While not statistically significant, we provide data demonstrating an apparent 40% reduction in AIS numbers in MS. We further provide qualitative evidence that AIS integrity in MS is not dependent on myelination suggestive that axonal pathology may be a primary event in MS, independent of demyelination. Our current findings are intriguing, but unfortunately this study is underpowered, and more samples will be required to determine whether this apparent reduction is statistically significant.
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Iacobaeus, Ellen. "Establishment and applications of a multiple sclerosis biobank analysis of biomarkers and therapeutic complications in MS /." Stockholm, 2010. http://diss.kib.ki.se/2010/978-91-7409-811-2/.
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Elderfield, Amber-Jayne. "Lipocortins in the central nervous system in multiple sclerosis and experimental allergic encephalomyelitis." Thesis, University of Bath, 1994. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.385288.
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Brecher, R. W. "Functional characteristics of Alpha-2-Macroglobulin in normal and Multiple Sclerosis sera." Thesis, University of Sussex, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.380499.
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Krökki, O. (Olga). "Multiple sclerosis in Northern Finland:epidemiological characteristics and comorbidities." Doctoral thesis, Oulun yliopisto, 2016. http://urn.fi/urn:isbn:9789526212388.
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Abstract Multiple sclerosis (MS) is the most frequent chronic inflammatory demyelinating disease of the central nervous system leading to neurological disability in young adults. Finland belongs to the high-risk areas of MS with continuously increasing of prevalence rates. In comparison to the general population, patients with MS have an increased risk of premature mortality. The extent of comorbidity rates and their role in the outcomes of MS have not been fully investigated. The aim of this thesis was to evaluate the epidemiology and survival of MS in Northern Ostrobothnia. The neurological comorbidity and frequency of fractures in patients with MS were also investigated. All MS patients diagnosed in Oulu University Hospital during 1990–2010 were included in this study. The prevalence of MS was 103/105; the mean overall incidence was 6.3/105. Women had a 2.3-fold higher MS incidence than men. The overall incidence figures were clearly affected by a pronounced increase among females. Neurological comorbidities were common in MS patients with 17.1 % of patients suffering from some other neurological diseases in addition with MS. The most common diseases were migraine (10.4 %) and epilepsy (4.7 %).The prevalence of stroke was similar in MS patients compared to the general population, but the 21-year survival rate was significantly lower in MS patients who had suffered a stroke compared with those MS patients without stroke. MS patients experienced a high risk for fragility fractures especially vertebral fractures. The possibility of osteoporosis had been examined only 26 % patients with fragility fractures and osteoporosis was detected in the majority. The prevalence of MS in our cohort was similar to the Finnish average, but in the Seinäjoki area, the prevalence was double the national average. Although the increasing incidence of female MS has been confirmed also in other studies, the reasons for this phenomenon are unknown. The increased risk for fragility fractures may be associated with low D vitamin levels or pathogenesis of MS. These findings emphasize the role of comorbid diseases in disability and survival of MS patients and attention should be paid to these conditions also in clinical practice<br>Tiivistelmä MS-tauti on nuorten aikuisten yleisin etenevä ja usein työkyvyttömyyteen johtava neuroimmunologinen sairaus. Suomi kuuluu korkean riskin alueeseen ja maassamme on havaittu alueellisia eroja MS-taudin esiintyvyydessä. MS-taudin ennusteeseen vaikuttavia tekijöitä ei täysin tunneta, mutta luonnollisen kulun tutkimuksissa on havaittu, että MS-tauti lyhentää eliniän ennustetta useita vuosia muuhun väestöön verrattuna. MS-tautia sairastavien potilaiden toimintakyvyn ja eliniän ennusteeseen vaikuttavista liitännäissairauksista on hyvin vähän tietoa. Tutkimuksen tarkoituksena oli selvittää MS-taudin epidemiologiaa sekä eliniän ennustetta Pohjois-Pohjanmaalla. Lisäksi tutkittiin MS-tautia sairastavien muuta neurologista sairastavuutta sekä luun murtumien esiintyvyyttä. Aineistona oli Oulun yliopistollisessa sairaalassa MS-taudin diagnoosin saaneet potilaat vuosilta 1990–2010. MS-taudin esiintyvyys oli 103/105 ja ilmaantuvuus keskimäärin 6.3/105. Naisilla MS-taudin ilmaantuvuus oli 2,3-kertainen miehiin verrattuna. MS-taudin ilmaantuvuus lisääntyi 15 vuoden seurannassa, mikä selittyi MS-taudin ilmaantuvuuden kasvulla naisten keskuudessa. MS-taudin lisäksi 17,1 %:lla potilaista oli jokin muu neurologinen sairaus. Yleisimmät sairaudet olivat migreeni (10,4 %) ja epilepsia (4,7 %). Neurologisista liitännäissairauksista aivoverenkiertohäiriöiden esiintyvyys oli yhtä suuri kuin väestössä yleensä, mutta sairastettu aivoverenkiertohäiriö lisäsi merkittävästi MS-potilaiden kuolleisuutta. MS-tautia sairastavilla havaittiin kohonnut riski etenkin matalaenergisiin murtumiin, joista merkittävä osuus oli selkärangan nikamamurtumia. Matalaenergisen murtuman saaneista potilaista luuntiheyden mittaus oli tehty vain 26 %:lle, joista suurimalla osalla todettiin osteoporoosi. Tutkimuksen perusteella MS-taudin esiintyvyys vastaa Suomen keskimääräistä esiintyvyyttä ja on noin puolet pienempi kuin Seinäjoen alueella, missä MS-taudin esiintyvyys on Suomen korkein. MS-taudin ilmaantuvuuden lisääntyminen naisten keskuudessa on havaittu myös muissa tutkimuksissa, mutta syy tähän ilmiöön on epäselvä. MS-tautia sairastavilla kohonnut murtumariski saattaa liittyä mataliin D-vitamiinipitoisuuksiin tai MS-taudin patogeneesiin. Koska liitännäissairastavuus sekä luunmurtumat heikentävät MS-tautia sairastavan toimintakykyä ja lisäävät kuolleisuutta, tulisi näihin kiinnittää enemmän huomiota myös kliinisessä työssä
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Vermöhlen, Vanessa, Petra Schiller, Sabine Schickendantz, et al. "Hippotherapy for patients with multiple sclerosis: A multicenter randomized controlled trial (MS-HIPPO)." Sage, 2018. https://tud.qucosa.de/id/qucosa%3A35527.
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Background: Evidence-based complementary treatment options for multiple sclerosis (MS) are limited.
Objective: To investigate the effect of hippotherapy plus standard care versus standard care alone in MS patients.
Methods: A total of 70 adults with MS were recruited in five German centers and randomly allocated to the intervention group (12 weeks of hippotherapy) or the control group. Primary outcome was the change in the Berg Balance Scale (BBS) after 12 weeks, and further outcome measures included fatigue, pain, quality of life, and spasticity.
Results: Covariance analysis of the primary endpoint resulted in a mean difference in BBS change of 2.33 (95% confidence interval (CI): 0.03–4.63, p = 0.047) between intervention (n = 32) and control (n = 38) groups. Benefit on BBS was largest for the subgroup with an Expanded Disability Status Scale (EDSS) ⩾ 5 (5.1, p = 0.001). Fatigue (−6.8, p = 0.02) and spasticity (−0.9, p = 0.03) improved in the intervention group. The mean difference in change between groups was 12.0 (p < 0.001) in physical health score and 14.4 (p < 0.001) in mental health score of Multiple Sclerosis Quality of Life-54 (MSQoL-54).
Conclusion: Hippotherapy plus standard care, while below the threshold of a minimal clinically important difference, significantly improved balance and also fatigue, spasticity, and quality of life in MS patients.
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Hoffman, Kathryn Elizabeth. "Reported pain in multiple sclerosis (MS) and its relationship with affect and attention." Thesis, University College London (University of London), 2007. http://discovery.ucl.ac.uk/1446315/.
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Pain is an important part of MS symptomatology. Studies, with other pain populations, suggest distress is associated with pain. However, models of the influence of psychological factors on pain have not been carefully applied and tested with the MS population. The hypothesis was: many patients do not classify much of their sensory disturbance as pain due to their conceptual framework and this may affect the relationship between pain and distress. A model of these factors was developed for MS patients. A clinic sample of MS patients, expected to have varying degrees of subjective pain, was recruited. Standard, adapted and new measures were used to characterise the population along the following dimensions: pain, level of cognitive ability (general intelligence and working memory) and cognitive bias, mood, and coping styles. Amount of distress was assessed using a semantic differential measure of wellbeing/distress, Survey of Pain Attitudes and Coping with MS Scale. A Pain Discomfort Scale was adapted to discern differences between people reporting "pain" versus those reporting "discomfort." Pain cognitive-processing bias was explored using assessments including a stem completion task, an experimental recall task using pain and illness words and a restructured Hayling sentence completion task. Power calculations showed that with 100 patients a detectable correlation would be 0.28 (p=0.05, power = 80%). Measures were compared using paired t-tests for repeated measures, independent t-tests for measures across patients, and regression modelling. McGill adjectives chosen were similar across both high and low pain responders. Participants reporting "pain" experienced significantly greater physical impact of MS whereas participants reporting "discomfort" experienced greater emotional distress. Cognitive bias towards pain, illness and MS related material was not linked with overall pain or disease state but with coping styles. A model of how emotional stressors affect reported pain in MS was created.
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Price, Sian Elen. "Multiple sclerosis and the genes and proteins of the central nervous system myelin." Thesis, University of Southampton, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.297377.
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Weatherby, Stuart J. M. "Visual, magnetic resonance, and genetic studies of outcome in multiple sclerosis." Thesis, Keele University, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.368980.
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Fox, Esther Elizabeth. "The effects of pilates based core stability training in people with MS." Thesis, University of Plymouth, 2015. http://hdl.handle.net/10026.1/3477.
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Background: People with Multiple Sclerosis experience difficulties with balance and mobility. Pilates exercises are often used to address these difficulties. Design: This was a multi-centre, double blind, block randomised, controlled trial. Eligible participants were recruited from seven UK centres. Participants were randomly allocated to either: Pilates based core stability training (Pilates), Standardised Exercise (SE) or Relaxation (placebo). All received face-to-face training sessions over a 12 week period; together with a home exercise programme. Blinded assessments were taken before training, at the end of the 12 week programme and at 16 weeks (follow-up). The primary outcome measure was the 10metre timed walk (10mtw). Secondary outcome measures were the MS walking Scale (MSWS-12), Functional Reach Test (FRT ) (forwards and lateral), a 10 point Visual Analogue Scale (VAS) to determine “Difficulty in carrying a drink when walking”, and the Activities-specific Balance Confidence (ABC) Scale. Effects on deep abdominal muscles were measured with ultrasound imaging (USI) in a subgroup of patients. Independent t-tests were performed to compare groups. Sensitivity analyses were undertaken to confirm the results. A mixed factorial ANOVA analysed the effect of intervention over time upon TrAb and IO upon USI. Results: Of the 100 participants recruited, 13 relapsed leaving 94 for intention to treat analysis. At 12 weeks there were significant differences between: (1) Pilates and Relaxation for walking velocity (p=0.04), forward (p=0.04) and lateral (p=0.04) FRT. (2) SE and Relaxation for all measures (p < 0.05) apart from the VAS. These remained at 16 weeks for 10mtw (p=0.04), LFR (p < 0.01) MSWS-12 (p=0.03) and ABC (p = 0.03). There were no significant interactions (p > 0.05) between groups or over time for TrAb and IO. Conclusions: Participants improved with both Pilates and SE in the short term; with broader and longer-lasting effects in the SE group. USI did not detect any effect of group over time.
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Tuke, Philip William. "Molecular techniques for the detection and characterisation of a novel retrovirus associated with multiple sclerosis." Thesis, University College London (University of London), 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.368078.
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McPheters, Justin Kade. "The role of MS patient and partner reports of couple relationship quality and depression in the physical functioning of MS patients." Related electronic resource: Current Research at SU : database of SU dissertations, recent titles available, full text:, 2008. http://wwwlib.umi.com/cr/syr/main.
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Duddy, Martin Edward. "The effect of INF-β on patterns of cytokine production and monocyte differentiation in multiple sclerosis." Thesis, Queen's University Belfast, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.322644.
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Croxford, J. Ludovic. "Gene therapy for experimental allergic encephalomyelitis by delivery of inhibitory cytokines or cytokine inhibitors." Thesis, University College London (University of London), 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.314201.
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Haase, Rocco, Jennifer S. Kullmann, and Tjalf Ziemssen. "Therapy satisfaction and adherence in patients with relapsing–remitting multiple sclerosis: the THEPA-MS survey." Sage, 2016. https://tud.qucosa.de/id/qucosa%3A35540.
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Background: Improved clinical effectiveness and therefore positive modification of multiple sclerosis (MS) with basic therapy can be achieved by long-term regular intake of drugs as prescribed but investigations have shown that a high percentage of patients do not take their medications as prescribed. Objectives: We assessed the satisfaction and adherence of patients with MS with their current disease-modifying treatment under clinical practice conditions. We compared different facets of satisfaction as well as their internal relationship and identified predictors in an exploratory manner.
Methods: Therapy satisfaction in patients with relapsing–remitting multiple sclerosis (THEPAMS) was a noninterventional, prospective cross-sectional study performed throughout Germany in 2013 and 2014, and included patients with clinically isolated syndrome or relapsing–remitting MS. We applied a standardized approach to document satisfaction and adherence by patient-reported outcomes (Treatment Satisfaction Questionnaire for Medication) as well as by physician ratings.
Results: Of 3312 patients with a mean age of 43.7 years, 73.3% were women and the mean level of disability according to the Expanded Disability Status Scale was 2.29; 13.3% did not receive any medication at the time of documentation, 21.3% received interferon β1a intramuscularly, 20.7% had interferon β1a subcutaneously, 17.0% had interferon β1b subcutaneously and 23.7% had glatiramer acetate. Adherence rates varied between 60% (lifetime) and 96.5% (current medication). Differences between current medications were found for side effects and convenience scores but not for effectiveness, satisfaction and adherence. Higher global satisfaction and effectiveness were associated with fewer relapses, longer duration of medication, lower disability score and the absence of several side effects.
Conclusion: In a connected model of patient satisfaction, effectiveness, side effects, convenience and adherence, patients’ individual needs and concerns have to be addressed. Most differences were found with respect to side effects and convenience of treatment. Therefore, an improvement in these two domains seems to be the most promising proximate approach to elevate adherence levels.
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Cordingly, Kimberly Lynne. "The emerging geographies of work and identity exploring alternative employment strategies and work subjectivities of women with multiple sclerosis (MS) /." Morgantown, W. Va. : [West Virginia University Libraries], 2007. https://eidr.wvu.edu/etd/documentdata.eTD?documentid=5302.
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Thesis (Ph. D.)--West Virginia University, 2007.<br>Title from document title page. Document formatted into pages; contains x, 415 p. : col. ill. Includes abstract. Includes bibliographical references (p. 324-368).
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Dirvanskiene, Ramune. "A longitudinal study of cognitive changes in MS : dimensionality, predictors and self-perception of change." Thesis, University of Edinburgh, 2016. http://hdl.handle.net/1842/22826.
Full textAbstract:
Background: Multiple sclerosis (MS) is a neurological disorder and the most frequent neurological cause of disability in young adults. 40-65% of MS patients experience cognitive difficulties (Bennedict et al., 2012), with problems in memory, attention and information processing speed being most frequently reported. However, visuoperceptual and language functions are much less studied in MS, but the few studies that looked into them (Vleugels, 2001; Grossman, 1995) have found prevalence of significant posterior deficits in MS. Up to today no study has investigated the domain-specificity of cognitive dysfunction in MS and its longitudinal progression. Aims: The primary aim of this project was to investigate the dimensionality of MS-related cognitive impairment longitudinally. The second aim was to determine the predictors of the observed longitudinal changes. The third aim was to investigate whether the participants themselves were aware of their cognitive changes, and what predicted the self-perception of change. Methods: To address these aims I followed a sample of MS patients and compared their performance on cognitive tests measuring five cognitive domains (verbal memory, visuospatial memory, processing speed, visuoperceptual and language) at baseline and at follow-up three years apart. Then I’ve composed separate models to explain the predictors first of the actual changes, and then of the perceived changes in performance. Moreover, as part of this project I have analysed pre-existing data to evaluate the instruments and optimized the baseline test battery for use in performing the followup assessments. Findings: I have managed to collect follow-up data on 82 MS patients and 23 matching healthy controls, acquiring high (76% and 79% respectively) recruitment rates. My MS sample (24% PPMS, 34% SPMS and 46% RRMS) was representable of the overall MS population. I found that deficits were seen in all cognitive domains (none were spared) and that new deficits were picked up sporadically, although with higher predisposition towards the information processing speed, visuoperceptual and memory domains. The new deficits showed the tendency to slowly accumulate, leading to development of major problems with longer disease duration. Interestingly it was found that even though the factors that influenced cognitive decline were specific for each of the cognitive domains, however, neurological disability, MS type and levels of depression were the most common predictors of change in cognitive functioning. I found that in general MS patients perceived longitudinal changes on the BRBN battery more accurately than on visuoperceptual and language tests, and the factors that played a role in the self-perception of change were executive dysfunction, neurological disability and MS impact. Implications: The results of this study add significant contribution to the field of longitudinal change in cognition in MS. Not only I explored the dimensionality of MS-related cognitive deficits, but also examined the factors that led to poorer performance, and the patients’ own perspective of their cognitive change. Moreover, with this project I have addressed common problems in the field of longitudinal research in MS – definition of normal variation in performance; the sensitivity of cognitive tests to pick up MS-related deficits; and heterogeneity of cognitive impairments in MS; - and I have used the performance of my own controls in attempts to account for all of that. I believe that this study will be of interest not only to those who specialize in cognitive functioning in MS, but also to those who question the methods employed in clinical research to define impairments and to account for individual differences.
26
Acosta, Crystal May R. "Antigenic induction of nerve growth factor (NGF) in experimental autoimmune encephalomyelitis (EAE), an animal model of multiple sclerosis (MS)." Bentham Science, 2013. http://hdl.handle.net/1993/23504.
Full textAbstract:
Nerve growth factor (NGF) represents a new therapeutic strategy for multiple sclerosis (MS) because of its immunomodulatory and neuroprotective activity. To analyze changes in NGF expression experimental autoimmune encephalomyelitis (EAE) was induced in Lewis rats. In the dorsal root ganglia (DRG) of animals with EAE, NGF mRNA and protein increased between 18 - 24 days post induction (dpi) during complete neurological recovery. In the spinal cord (SC) of animals with EAE, NGF mRNA and protein expression increased at 15 dpi and 12 dpi, respectively, to reduce EAE-induced disability. We identified the 25 kDa pro-NGF as a biologically active isoform during EAE. EAE SC axons demonstrate a loss or thinning of myelin which correlated with maximal neurological disability. NGF plays a role in minimizing EAE-induced inflammation and myelin damage to promote neurological recovery. NGF may be an “off switch” for a cytokine-neurotrophin signaling triad to govern the extent of myelin damage.
27
Huss, David J. "Effector Th1 cells demonstrate self-regulation in a mouse model of Multiple Sclerosis." The Ohio State University, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=osu1305118647.
Full text
28
Raask, Pontus, and Oskar Salomonsson. "Att leva med MS : En studie av självbiografier." Thesis, University of Skövde, School of Life Sciences, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-1080.
Full textAbstract:
<p>Att bli diagnostiserad med en kronisk sjukdom som Multipel Skleros (MS) kan vara förödande både fysiskt och psykiskt. Det beror mycket på hur personen med MS hanterar sin nya situation. Studier visar att det finns många sätt att hantera sjukdomen på. Detta kan sammanfattas som copingfaktorer. Syftet med denna studie var att, baserat på självbiografier, beskriva utmärkande copingfaktorer hos personer med Multipel Skleros. Studien har en kvalitativ ansats och åtta självbiografier lästes och analyserades. Resultatet visar att personer hanterar sin sjukdom på många olika sätt. Utmärkande copingfaktorer sammanfattades i sex teman med underliggande subteman: Få närståendes kärlek, Kunskapstillväxt, Få tala ut, Drivkrafter, Ta emot hjälp och Acceptera det nya livet. Det är av stor vikt att sjuksköterskor och övrig sjukvårdspersonal ökar sin kunskap om copingfaktorer för att få en ökad förståelse för personer med MS och därmed lättare kunna identifiera var extra kraft ska läggas.</p><br><p>To be diagnosed with a chronic disease like Multiple Sclerosis (MS) can be devastating both physically and psychologically. Much depends on how well the person with MS can handle the situation. Studies show that there are many different ways to handle the disease, this can be summarized as coping-factors. The aim of this study was describe salience coping-factors in persons with Multiple Sclerosis based on self-biographies. The study has a qualitative approach and eight self-biographies were read and analyzed. The result shows that people handle their disease in different ways. Salience coping-factors where summarized into themes. Six themes with subthemes were created; to get relatives love, to achieve knowledge, to talk out, driving forces, to accept help and to accept the new life. It is of great importance that medical staff increases their knowledge about coping-factors to achieve a greater understanding for persons with MS. Therefore it is easier to know what areas to prioritize.</p>
29
Cartemo, Maria, Frida Starck, and Elin Larsson. "Hur vardagslivet gestaltar sig hos patienter med diagnosen ALS och MS : En studie gjord för att öka kunskapen och förståelsen hos sjuksköterskan." Thesis, University of Skövde, School of Life Sciences, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-1060.
Full textAbstract:
<p>Amyotrofisk lateralskleros och multipel skleros är båda neurologiska sjukdomar som orsakar fysiska begränsningar och påverkar vardagslivet. Syftet med studien var att undersöka hur vardagslivet gestaltar sig för dessa patienter. Studien baseras på en kvalitativ metod utifrån sex självbiografier och en biografi, vilket ger en insyn i patienternas egna upplevelser av hur det är att leva med ALS eller MS. Resultatet består av fyra huvudteman; Relationer, Begränsningar, Psykisk hälsa och Tankar. I samband med sjukdomen blir relationer mer betydelsefulla samtidigt som den för med sig påfrestningar i förhållandet. Begränsningarna kan leda till att den sjuke får allt svårare att klara av sin vardag vad det gäller hemmet, fritiden samt arbete. Den psykiska hälsan kan yttra sig som depression och det blir en daglig kamp där de söker mening med livet och försöker ta kontroll över situationen. Tankarna handlar om nya värderingar i livet och deras ovisshet om framtiden samt att acceptera situationen. Denna studie kan öka sjuksköterskans kunskap och förståelse för patientens situation, samt vara till hjälp vid individanpassningen av omvårdnaden för dessa patienter. Den kan även vara till hjälp för andra personer som vårdar dessa patienter, som till exempel anhöriga och annan ansvarig vårdpersonal.</p><br><p>Amyotrophic lateral sclerosis and multiple sclerosis are both neurological diseases that cause physical limitations and have consequences on daily life. The aim of this study was to clarify how this daily life appears for these patients. The study is based on a qualitative method with six autobiographies and one biography, which gives an insight of their own, lived experiences on how it is to live with ALS or MS. The result contains four main subjects; Relations, Limitations, Psychical health and Thoughts. In sickness relations becomes more of value, but it also cause stress within a relationship. The limitations make life more difficult in different aspects, such as home environment, leisure activities and work. The mental health can develop into a depression and it becomes a daily fight where they seek a meaning with life and try to take control over the situation. Thoughts are about new values in life, an uncertainty about the future and to accept the situation. The findings of this study can give nurses more knowledge and understanding and be helpful when adjusting nursing care for each of these individuals. It can also be a help to other people who take care of these patients, such as family members and other involved care staff.</p>
30
Blomberg, Carolina. "Intrathecal and Systemic Complement Activation Studies of Multiple Sclerosis and Guillan-Barré Syndrome." Thesis, University of Kalmar, School of Pure and Applied Natural Sciences, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:hik:diva-2032.
Full textAbstract:
<p>Both Multiple Sclerosis (MS) and Guillan-Barré syndrome (GBS) are neurological inflammatory demyelinating autoimmune diseases, with a probable antibody contribution. Complement proteins in both MS and GBS does play a role in inflammation and demyelination at pathogenesis, according to earlier scientific evidence. The aim of this examination project work was to investigate systemic and intrathecal complement activation in MS and GBS, to gain further knowledge that might be useful for development of future therapeutics targeting immune responses during those diseases. An additional aim was to develop a new ELISA method for detection of complement iC3.</p><p>By using sandwich ELISA, complement proteins C1q, C4, C3, fH and C3a were measured in plasma and cerebrospinal fluid (CSF) from persons within 4 different diagnostic groups; MS, other neurological diseases (OND), GBS and controls (C). An ELISA method to detect iC3 (hydrolysed C3) was also developed, including usage of SDS-PAGE. Results based on raw data and statistical analysis show significantly elevated levels of C3a (C3a/C3) in MS and decreased C3 in plasma. In CSF low levels of C4 and C3a/C3 in MS were detected, though correlation of C3a and C1q was positive. GBS reveal high levels of all complement proteins analysed in CSF except for C3, and a positive correlation of C3a and C1q as well as C3a and fH was found.</p><p>These results indicate that MS patients have systemic complement activation; however the activation pathway is not determined. Complement activation in MS may also occur intrathecally, with correlation analysis indicating a possible activation via the classical pathway. MS patients suffering from a more acute relapsing-remitting (RR) MS have a more prominent systemic complement activation compared to MS patients responding to beta-interferon treatment. Systemic increased C3a/C3 ratio may be a possible biomarker to distinguish more acute RR MS in an earlier step of MS pathogenesis and should be further investigated. GBS patients have an intrathecal complement activation that seems to occur via the classical pathway.</p>
31
Sjöberg, Susanne. "The Ytterby mine - A historical review and an evaluation of its suggested spatial coupling to multiple sclerosis (MS)." Thesis, Stockholms universitet, Institutionen för geologiska vetenskaper, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-84521.
Full textAbstract:
The Ytterby mine is located on Resarö island in the Stockholm archipelago. Mainly feldspars but also quartz were historically quarried in the mine, which is also the place of discovery of seven rare earth elements (REE). During the cold war era, the mine shaft was used as a diesel and jet fuel deposit for the Swedish Armed Forces. Recently, a spatial coupling between multiple sclerosis (MS), a chronic neurodegenerative disease in the central nervous system, prevalence and the quarry has been suggested. Previous studies show that adverse neurological health effects are associated with oral intake of REEs and there is support for a coupling between ionizing radiation and MS. The extent and character of health effects as a result of exposure to petroleum products are still debated. However, a substantial number of scientific reports support a coupling between neurodegenerative health effects and toxic constituents of jet fuels such as benzene, toluene, and n-hexane. My data show that a possible overrepresentation of MS patients within the Ytterby postal code area could be an indication of a spatial coupling between the mine and MS. Such a possible coupling could be associated with the REEs present in the local rocks, with the previous storage of diesel or jet fuel MC-77 in the mine and/or with zones of high natural radioactivity in the area. Water samples collected in 15 wells in the Ytterby village show traces of five REEs, i.e. scandium (Sc), yttrium (Y), lanthanum (La), neodymium (Nd) and samarium (Sm) and the majority of sample locations at low ground elevation show contamination of diesel which is the most recent fuel stored in the mine. Moreover, results from an analysis of a black substance leaking out of cracks in the mine corridors confirm that REEs are present in substantial concentrations in the local rocks and also appear to be mobile. This should be taken into account when considering a potential contamination of the local water supply. Measurements of natural radioactivity have also been made around the contours of the quarry and zones of high ionizing radiation have been identified. By using these zones of high ionizing radiation as a proxy for rare minerals containing rare earth elements, I further suggest that the REE occurrences are highly localized around the quarry and could be associated with, or remobilized by, younger faults. My data show that a full investigation is warranted of a possible spatial coupling between neurological health issues, MS being one of them, and the mine.
32
Douglas, Clint. "The impact of pain on the quality of life of people with multiple sclerosis." Thesis, Queensland University of Technology, 2007. https://eprints.qut.edu.au/16523/1/Clint_Douglas_Thesis.pdf.
Full textAbstract:
This thesis was concerned with determining the scope, nature and impact of pain on quality of life (QOL) among a community-based sample of people with multiple sclerosis (MS). An analysis of the research literature on pain in MS reveals that pain is a significant problem which has historically been underinvestigated and is currently poorly understood. The vast majority of the published literature consists of prevalence studies, descriptive research and clinical reports. Where available, empirical data are often limited by methodological and analytical problems such that substantive conclusions about the scope and nature of MS-related pain remain unclear. Among the most fundamental issues is the extent to which pain is problematic in a population which is already impaired by other physical disabilities. Little is known about how pain contributes to MS-related disability, distress and QOL. Moreover, research examining the psychosocial aspects of MS-related pain is noticeably absent. It is clear that there are substantial gaps in the literature and that many basic questions about the scope, nature and impact of pain problems among individuals with MS remain unanswered. Thus the primary aim of this study was to begin to fill some of these gaps by systematically investigating the following research questions: (1) What is the prevalence and nature of pain experienced by people with MS? (2) What is the impact of pain on the QOL of people with MS, over and above the impact of disability itself? (3) To what extent do physical and psychosocial factors influence adjustment to chronic pain in people with MS? (4) What meaning is given to the pain experience by people with MS?
The present study utilised a multimethod research design involving cross-sectional postal survey, structured in-person pain interviews and focus groups. Survey respondents were a 219-person sample recruited from the Queensland MS Society membership database via systematic random sampling. All participants completed a piloted questionnaire containing questions about their demographic and clinical characteristics, validated measures of QOL and MS-related disability, and a question on whether or not they had experienced clinically significant pain in the previous two weeks. Respondents who reported pain then completed face-to-face structured pain interviews assessing pain characteristics (viz. intensity, quality, location, extent and duration), pain-related beliefs and coping strategies, and pain management techniques used. Four focus groups were also conducted that included 32 people with MS living in the community. Study participants were a purposive sample drawn from four MS support groups located in the South-East Queensland region.
Pain was found to be common with some 67.1% of the sample reporting pain during the two weeks preceding the study. Comprehensive pain assessment revealed that a substantial subset of these individuals experience chronic pain conditions characterised by moderate-to-severe pain intensity. Pain prevalence and intensity were found to be strongly correlated with QOL: physical health, psychological health, level of independence and global QOL were more likely to be impaired among people with MS when pain was present, and the extent of impairment was associated with the intensity of pain. Moreover, these relationships remained significant even after statistically controlling for multiple demographic and clinical covariates associated with self-reported QOL. Pain-related beliefs and coping strategies were also associated with and explained a significant proportion of the variance in adjustment to pain among people with MS, over and above that accomplished by demographic and MS-related variables and pain intensity. Finally, qualitative data analysis revealed four broad conceptualisations of the experience of chronic MS-related pain including: pain is pervasive, nobody understands, I'm fine, and always a factor in the equation.
These findings suggest that for people with MS, pain is an important source of distress and disability over and above that caused by neurological impairments. These data also lead to the hypothesis that recognition and effective treatment of pain would improve the QOL of people with MS, irrespective of their level of neurologic disability. Although correlational, the findings provide support for a biopsychosocial model of pain and adjustment to pain in people with MS.
33
Douglas, Clint. "The impact of pain on the quality of life of people with multiple sclerosis." Queensland University of Technology, 2007. http://eprints.qut.edu.au/16523/.
Full textAbstract:
This thesis was concerned with determining the scope, nature and impact of pain on quality of life (QOL) among a community-based sample of people with multiple sclerosis (MS). An analysis of the research literature on pain in MS reveals that pain is a significant problem which has historically been underinvestigated and is currently poorly understood. The vast majority of the published literature consists of prevalence studies, descriptive research and clinical reports. Where available, empirical data are often limited by methodological and analytical problems such that substantive conclusions about the scope and nature of MS-related pain remain unclear. Among the most fundamental issues is the extent to which pain is problematic in a population which is already impaired by other physical disabilities. Little is known about how pain contributes to MS-related disability, distress and QOL. Moreover, research examining the psychosocial aspects of MS-related pain is noticeably absent. It is clear that there are substantial gaps in the literature and that many basic questions about the scope, nature and impact of pain problems among individuals with MS remain unanswered. Thus the primary aim of this study was to begin to fill some of these gaps by systematically investigating the following research questions: (1) What is the prevalence and nature of pain experienced by people with MS? (2) What is the impact of pain on the QOL of people with MS, over and above the impact of disability itself? (3) To what extent do physical and psychosocial factors influence adjustment to chronic pain in people with MS? (4) What meaning is given to the pain experience by people with MS? The present study utilised a multimethod research design involving cross-sectional postal survey, structured in-person pain interviews and focus groups. Survey respondents were a 219-person sample recruited from the Queensland MS Society membership database via systematic random sampling. All participants completed a piloted questionnaire containing questions about their demographic and clinical characteristics, validated measures of QOL and MS-related disability, and a question on whether or not they had experienced clinically significant pain in the previous two weeks. Respondents who reported pain then completed face-to-face structured pain interviews assessing pain characteristics (viz. intensity, quality, location, extent and duration), pain-related beliefs and coping strategies, and pain management techniques used. Four focus groups were also conducted that included 32 people with MS living in the community. Study participants were a purposive sample drawn from four MS support groups located in the South-East Queensland region. Pain was found to be common with some 67.1% of the sample reporting pain during the two weeks preceding the study. Comprehensive pain assessment revealed that a substantial subset of these individuals experience chronic pain conditions characterised by moderate-to-severe pain intensity. Pain prevalence and intensity were found to be strongly correlated with QOL: physical health, psychological health, level of independence and global QOL were more likely to be impaired among people with MS when pain was present, and the extent of impairment was associated with the intensity of pain. Moreover, these relationships remained significant even after statistically controlling for multiple demographic and clinical covariates associated with self-reported QOL. Pain-related beliefs and coping strategies were also associated with and explained a significant proportion of the variance in adjustment to pain among people with MS, over and above that accomplished by demographic and MS-related variables and pain intensity. Finally, qualitative data analysis revealed four broad conceptualisations of the experience of chronic MS-related pain including: pain is pervasive, nobody understands, I'm fine, and always a factor in the equation. These findings suggest that for people with MS, pain is an important source of distress and disability over and above that caused by neurological impairments. These data also lead to the hypothesis that recognition and effective treatment of pain would improve the QOL of people with MS, irrespective of their level of neurologic disability. Although correlational, the findings provide support for a biopsychosocial model of pain and adjustment to pain in people with MS.
34
Herbert, Estelle Penelope. "Magnetic Resonance Imaging and Biochemical markers to assess disability in female subjects with Multiple Sclerosis." Thesis, Cape Peninsula University of Technology, 2016. http://hdl.handle.net/20.500.11838/2404.
Full textAbstract:
Thesis (M.Sc (Radiography))--Cape Peninsula University of Technology, 2016.<br>Multiple sclerosis (MS) affects the central nervous system (CNS) and is
characterized by multiple demyelinating lesions. It is in this context that a need arises for
reliable biomarkers such as Magnetic Resonance Imaging (MRI), which could lead to the
early diagnosis and therapeutic intervention when maximum potential impact is possible.
This study examines the impact of MRI as a marker and the sequences that give the best
images to aid in evaluation of disease progression (which can indirectly be seen as disability)
and the early diagnosis of MS which will, in turn, lead to more effective management of the
disease.
METHOD: Sixteen subjects underwent a neurological examination, the Expanded Disability
Status Scale (EDSS), blood tests for iron parameters and a 3Tesla Magnetic Resonance
Imaging (MRI) scan. In a study of MS, 11 had MRI data that could be analysed by using
tract-based spatial statistics (TBSS). Subjects were divided according to the EDSS score (8
of the subjects had an EDSS score of ≤ 3 while 3 subjects had scores of ≥ 6). Diffusion
tensor imaging (DTI), the fused Proton Density and Fluid Attenuation Recovery (FLAIR) was
utilised to compute the lesion numbers and standard laboratory procedures were used to
measure other biochemical markers (serum iron, % transferrin saturation, ferritin,
haemoglobin) in subjects with disability and simultaneously assess the disease process.
RESULTS: The FA of white matter tracts (WMTs) as a parameter of myelin integrity was
lower in subjects with MS only in those who had high EDSS scores. An association between
FA and iron parameters, especially percentage transferrin saturation (% Tf) sat were
observed, which suggests that iron availability to the WM may be a requirement for optimal
myelin functionality.
CONCLUSION: The FA of WMTs as a parameter of myelin integrity was lower only in those
MS subjects who had high EDSS scores. Subjects who had EDSS scores < 3 (i.e. who had a
“benign” disease outcome) had FA values similar to control values and this finding was not
related to their age or disease duration. The association found between FA and iron
parameters, especially % Tf sat, suggests that iron availability to the WM may be a
requirement for optimal myelin functionality. Results also suggest that serum iron
concentration, ferritin and % Tf sat had an effect on myelination. The lack of association
between FA and Hb suggests that the iron in this protein is not available for WM function.
35
Davis, William Henry. "Development of a high-throughput genotyping assay for detection of functional polymorphisms involved in homocysteine metabolism and the methylation process implicated in multiple sclerosis." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/95457.
Full textAbstract:
Thesis (MMedSc)--Stellenbosch University, 2013.<br>ENGLISH ABSTRACT: The aetiology of multiple sclerosis (MS) remains largely unknown due to the
multifactorial nature of disease susceptibility determined by both environmental and
genetic factors. Progress has been made in identifying the genetic component of MS
,
as well as the possible interactions with the environment. In this study single
nucleotide polymorphisms (SNPs) in the
FTO
(rs9939609, Intron 1 T>A),
MTR
(rs1805087, 2756 A>G),
MTRR
(rs1801394, 66 A>G),
MTHFR
(rs1801133, 677 C>T
and
rs1801131, 1298 A>C) and
COMT
(rs4680, 472 G>A) genes involved in the
methylation metabolic pathway were studied in the context of MS.
The overall objective of this study was to elucidate the mechanism underlying raised
homocysteine levels in MS patients. The specific aims were 1) to analytically validate
high throughput real-time polymerase chain reaction (RT-PCR) genotyping assays
for the 6 selected SNPs against direct sequencing as the gold standard for 2)
possible integration into a pathology-supported genetic testing strategy aimed at
improved clinical management of MS. The study population included a total of 114
unrelated Caucasian MS patients (98 females and 16 males) and 195 unrelated
Caucasian control individuals without a diagnosis of neurological disease (128
females and 67 males).
A novel finding of this study was that the risk-associated FTO rs9939609 A-allele was
associated with raised homocysteine levels (p=0.003) in patients diagnosed with MS,
but not in controls. Furthermore, homocysteine levels correlated significantly with
bo
dy mass index (BMI) (p=0.046) and total cholesterol levels (p=0.048). Both
homocysteine (p=0.011) and BMI (p=0.017) were significantly reduced with
increasing intake of folate in the diet, while high saturated/trans fat intake correlated
significantly with increased BMI (p<0.001). High physical activity correlated with
reduced BMI (p<0.006) in the study population, adjusted for age, gender and disease
status. Daily intake of at least five fruit and vegetable portions and the
COMT
rs4680
(472 G>A) AA genotype had a favourable lowering effect on MS disability as
assessed by the expanded disability status scale (EDSS) (p=0.035), while smoking
increased MS disability significantly (p<0.001). All SNPs studied were found to be in
Hardy-Weinberg equilibrium (HWE), with no significant differences detected between
patients and control individuals in genotype distribution or allele frequencies. This study has shown for the first time that the underlying disease process of MS
moderates the effect of the FTO rs9939609 polymorphism on homocysteine levels
,
which is consistent with the role of FTO in demethylation and epigenetic changes.
Identification of FTO rs9939609 reinforces the importance of adequate folate intake
in the diet that can be assessed accurately with use of the Medical History and
Lifestyle Questionnaire applied in this study.
Finally, the finding that raised homocysteine levels and BMI are significantly
influenced by lifestyle factors such as diet and physical activity in our study cohort
,
offers a solution to counteract the detrimental effects of genetic risk factors
contributing to the development of these established vascular risk factors for MS.
Combining this information with
FTO
rs9939609 and
COMT
rs4680 genotyping may
in future translate into a comprehensive pathology supported genetic testing strategy
aimed at improved risk management and quality of life in MS patients.<br>AFRIKAANSE OPSOMMING: Die etiologie van meervoudige sklerose (MS)
is
grootliks onbekend as gevolg van die
multifaktoriale aard van siekte vatbaarheid wat bepaal word deur beide genetiese en
omgewingsfaktore. Vordering is reeds gemaak in die identifisering van die genetiese
component van MS, asook moontlike interaksie met die omgewing. In hierdie studie
is enkel nukleotied polimorfismes (SNPs) in die
FTO
(rs9939609, Intron 1 T > A),
MTR
(rs1805087, 2756 A> G),
MTRR
(rs1801394, 66 A> G),
MTHFR
(rs1801133,
677 C > T en rs1801131, 1298 A> C) en
COMT
(rs4680, 472 G > A) gene, wat
betrokke is in die metilering metaboliese padweg, in die konteks van
MS
bestudeer.
Die oorhoofse doel van hierdie studie was om die onderliggende meganisme
betrokke by verhoogde homosisteïen vlakke in MS pasiënte uit te lig. Die spesifieke
doelwitte was 1) om die analitiese geldigheid van die hoë deurvoer riëeltyd
polymerase kettingreaksie (RT-PCR) genotipering metode soos toegepas vir die 6
geselekteerde SNPs te bevestig teen direkte DNA volgorde bepaling as die goue
standaard, vir 2) moontlike integrasie in 'n patologie-gesteunde genetiese toetsing
(PSGT) stategie wat gemik is op verbeterde kliniese hantering van MS. Die
studiepopulasie bestaan uit 'n totaal van 114 nie-verwante Kaukasiese
MS
pasiënte
(98 vroue en 16 mans) en 195 nie-verwante Kaukasiese kontroles sonder
‘n
diagnose van neurologiese siektes (128 vroue en 67 mans).
'n Nuwe bevinding van hierdie studie was dat die risiko-verwante
FTO
rs9939609 A-
alleel geassosieer was met verhoogde homosisteïen vlakke (p = 0,003) in pasiënte
gediagnoseer met MS, maar nie in kontroles nie. Homosisteïen vlakke was verder
beduidend geassosieer met liggaamsmassa-indeks (BMI) (p=0,046) en totale
cholesterol vlakke (p=0.048). Beide homosisteïen (p=0,011) en BMI (p=0,017) het
aansienlik verminder met 'n hoër inname van folaat in die dieet, terwyl 'n hoë
versadigde/trans vet en koolhidrate inname beduidend gekorreleer het met 'n
verhoogde BMI (p <0.001). Hoë fisiese aktiwiteit was gekorreleer met 'n verminderde
BMI (p< 0.006) in die gekombineerde groep, aangepas vir die ouderdom, geslag en
MS diagnose. Daaglikse inname van ten minste vyf vrugte en groente porsies en die
COMT
rs4680 (472 G>A) AA genotipe het 'n gunstige uitwerking op vermindering
van gestremdheid gehad, soos bepaal deur die uitgebreide gestremdheid status
skaal (EDSS) (p=0,035), terwyl rook MS gestremdheid beduidend verhoog het (p
<0.001). Alle SNPs bestudeer was in Hardy-Weinberg ewewig (HWE), met geen beduidende verskille waargeneem in genotipe verspreiding of alleelfrekwensies
tussen pasiënte en kontroles nie.
Hierdie studie het vir die eeste keer
aangetoon dat ‘n diagnose van MS die effek van
die FTO rs9939609 polimorfisme op homosisteïen vlakke modereer, wat ooreenstem
met die rol van FTO in demetilering en epigenetiese veranderinge. Identifikasie van
FTO rs9939609 versterk die belangrikheid van genoegsame folaat inname in die
dieet wat akkuraat gemeet kon word deur gebruik te maak van die Mediese
Geskiedenis en Leefstyl Vraelys soos toegepas in hierdie studie.
Ten slotte, die bevinding dat verhoogde homosisteïen vlakke en BMI statisties
betekenisvol beïnvloed word deur leefstylfaktore soos dieet en fisiese aktiwiteit in ons
studie populasie, verskaf 'n oplossing om die genetiese bydrae tot hierdie gevestigde
vaskulêre risikofaktore vir MS teen te werk. Kombinasie van hierdie inligting met
FTO
rs9939609 en COMT rs4680 genotipering kan moontlik in die toekoms benut word as
deel van 'n omvattende patologie-
gesteunende genetiese toetsing strategie wat
daarop gemik is om die risikobestuur en kwaliteit van lewe te verbeter in MS
pasiënte.
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Söderholm, Simon. "The Complex Genetics of Multiple Sclerosis : A preliminary study of MS-associated SNPs prior to a larger genotyping project." Thesis, Linköpings universitet, Institutionen för fysik, kemi och biologi, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-129423.
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Biomedical research have been revolutionized by recent technological advances, both in the fields of molecular biology and computer science, turning the biomolecular and genetic research into “big data science”. One of the main objectives have been to improve our understanding of complex human diseases. Among those diseases, multiple sclerosis (MS) is considered as one of the most common. MS is a chronic autoimmune disease that cause inflammation and damage to the central nervous system. In this study, a set of bioinformatics analyses have been conducted on SNP data, as an initial step to gain more information prior to an upcoming genotyping project. The results showed extensive regulatory properties for the 761 selected SNPs, which is consistent with current scientific knowledge, and also identified another 332 SNPs in linkage to these. However, during the study some issues have also been identified, which need to be addressed going forward.
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Wynia, Klaske. "The Multiple Sclerosis Impact Profile (MSIP), an ICF-based outcome measure for disability and disability perception in MS development and psychometric testing /." [S.l. : [Groningen : s.n.] ; University Library Groningen] [Host], 2008. http://irs.ub.rug.nl/ppn/.
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Mickens, Melody N. "TODO EN LA FAMILIA: EXAMINING THE RELATIONSHIPS AMONG MS IMPAIRMENTS, FAMILY NEEDS, AND CAREGIVER MENTAL HEALTH IN GUADALAJARA, MEXICO." VCU Scholars Compass, 2014. http://scholarscompass.vcu.edu/etd/3930.
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Individuals with multiple sclerosis (MS), especially those living in Latin America, often require assistance from family caregivers throughout the duration of disease. Previous findings suggest that family caregivers may experience positive and negative effects from providing care to individuals with MS, but few studies have examined the impact of MS caregiving on caregivers from Latin America. The current study examined the relationships between MS impairments (functional, neurological, cognitive, behavioral and emotional), unmet family needs (household, informational, financial, social support, health), and caregiver psychosocial functioning (satisfaction with life, anxiety, burden, and depression) in a sample of 81 MS caregivers from Guadalajara, Mexico. Canonical correlations revealed that behavioral impairments were associated with higher burden and decreased satisfaction with life, and that unmet financial, social support, and informational needs were associated with higher caregiver burden. A structural equation model demonstrated the meditational effect of unmet family needs on the relationship between MS impairments and caregiver mental health. These findings suggest that interventions for MS caregivers in Latin America should focus on reducing caregiver burden by addressing unmet family needs for information, financial, and social support while teaching caregivers ways to manage the patient’s behavioral symptoms.
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Gillisdotter, Anna. "Att delta i en Fatigue Management kurs – upplevelser från personer med MS-fatigue." Thesis, Luleå tekniska universitet, Hälsa och rehabilitering, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-67521.
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Syftet med denna studie var att beskriva hur personer med MS-fatigue upplever upplägg och innehåll i FM-kursen, samt vilken betydelse de upplever att kursen haft för deras möjligheter att hantera sin MS-fatigue i vardagen. En kvalitativ metod med semistrukturerade intervjuer användes. Data är analyserad med riktad kvalitativ innehållsanalys. Resultatet visade att deltagarna upplevde att kursen var lärorik men ansträngande. Samtidigt gav kursen dem kunskap och strategier för att hantera MS-fatigue i vardagen. Huvudfyndet anses vara hur deltagarna upplever kursen stöttat dem hantera MS-fatiguen i vardagen genom användning av strategier och hjälpmedel. I diskussionen tas aspekten av resultatet om hur deltagarna blivit mer aktiva trots de infört vila i relation till aktivitetsbalans. Även aspekten om arbetsterapeutens expertis inom hjälpmedel och stödja deltagarna i användning av detta kunde möjliggöras i kursen. Konklusionen är att fler studier behövs för att studera Fatigue Management påverkan på aktivitet ur aktivitetsbalansperspektivet.<br>The purpose of this study was to describe how people with MS fatigue experience the structure and content of the FM course, and if the course helped them to handle their MS fatigue in their daily lives. A qualitative method of semi structured interviews was used. Data is analysed with directed qualitative content analysis. The result shows that the participants felt that the course was educative but strenuous. The course gave them knowledge and strategies for managing MS fatigue in everyday life. The main finding is considered how the participants experience the course supported them managing the MS fatigue in everyday life through the use of strategies and tools. In the discussion, the aspect of the result of how participants became more active, despite the added rest in relation to the activity balance, is taken. The aspect of the occupational assistant's expertise in assistive devices and supporting participants in using this could also be made possible in the course. The conclusion is that more studies are needed to study Fatigue Management's impact on activity from the activity balance perspective.
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Conway, Devon S. "Long-Term Benefits of Early Treatment in Multiple Sclerosis: An Investigation Utilizing a Novel Data Collection Technique." Case Western Reserve University School of Graduate Studies / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=case1307635721.
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Jansson, Gertie, and Rose-Marie Eriksson. "Människors upplevelser av olika symtom i samband med depression vid sjukdomarna MS och ALS : En studie av självbiografier." Thesis, University of Skövde, School of Life Sciences, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-3049.
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<p>Vid MS och ALS förekommer depressioner i olika nyanser, vilket är viktigt för</p><p>sjuksköterskan att fånga upp tidigt och ge den omvårdnad individen behöver samt att minska lidandet. För att detta skall kunna uppnås är det viktigt att den som är sjuk känner trygghet och tillit i sin relation till sjuksköterskan. Syftet med studien var att beskriva människors upplevelser av olika symtom i samband med depression som förekommer vid MS och ALS. För att fånga upp människors upplevelser av symtom i samband med depression användes en kvalitativ metod. Data samlades in genom åtta självbiografier som var skrivna på svenska av både kvinnor och män. En kvalitativ metod enligt Dahlberg användes för att tolka dessa data. Resultatet presenterades i varje sjukdom för sig i kategorier och underkategorier. Kategorier i MS var trötthet, förnekelse, skam, rädsla och tankar på döden. Kategorierna i ALS var, de gråter ut sin sorg, att tära på varandra, att behöva ta emot hjälp och tankar på döden. Resultatet visade skillnad i depressioner mellan dessa två sjukdomar. Vid MS är depressionerna djupare och längre då sjukdomen går i skov, medan det i ALS förändras från att vara djupa depressioner i samband med diagnos, till något positivt då de har kort tid kvar i livet.</p><br><p>When having MS and ALS there is also prevalence of depression of varying degree. This is important for the nurse to detect early in order to give the individual the right amount of care, to minimise suffering. In order to achieve this; it is important that the patient feels trust and security in the relation with the nurse. The aim of this study was to describe people's experiences of various symptoms associated with depression in MS and ALS, through the use of autobiographies. A qualitative method was used to gather the individual's experience of depression. Data was collected from eight autobiographies written in Swedish by both women and men. To interpret the data, a qualitative method, according to Dahlberg, was used. The results was separately for the two diseases, and was categorised and sub-categorised. The categories for MS were fatigue, denial, shame, fear and thoughts of death. The categories for ALS was, crying out grief, absume eachothers energy, help dependency and thoughts of death. The results showed differences in the state of depression between the two diseases. For MS, the depression goes deeper and for a longer duration, since the disease progresses in relapse. For ALS, the condition changes from deep depression when diagnosed to somewhat more positive when there are only little time left in life.</p>
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Lopes, Josiane. "Adaptação transcultural e avaliação das propriedades psicométricas da versão brasileira do Neurological Fatigue Index for Multiple Sclerosis (NFI-MS/BR)." Universidade Estadual de Londrina. Centro de Ciências da Saúde. Programa de Pós-Graduação em Ciências da Saúde, 2013. http://www.bibliotecadigital.uel.br/document/?code=vtls000187155.
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Introdução: A fadiga constitui o sintoma mais frequente e incapacitante na esclerose múltipla (EM). Entretanto, sua avaliação é limitada pela carência e falhas psicométricas dos instrumentos disponíveis. O questionário Neurological Fatigue Index for multiple sclerosis (NFI-MS) avalia a fadiga na EM de forma específica, sendo desenvolvido e validado de acordo com os parâmetros psicométricos preconizados, porém, está disponível somente no contexto cultural-idiomático britânico e holandês. Objetivo: adaptar transculturalmente o questionário NFI-MS para a língua portuguesa e cultura brasileira, bem como avaliar suas propriedades psicométricas para avaliação da fadiga em indivíduos com EM. Metodologia: A versão brasileira do NFI-MS (NFI-MS/BR) foi desenvolvida por meio de processo de tradução, retrotradução, revisão de um comitê de especialistas e teste de campo em 30 indivíduos com EM. Na análise psicométrica foram avaliados 210 indivíduos. Os 30 primeiros indivíduos foram submetidos à aplicação do NFI-MS/BR pelos entrevistadores A e B no mesmo dia e reteste após 7 dias, pelo entrevistador A. Os demais 180 indivíduos responderam os seguintes questionários: escala de severidade da fadiga, escala modificada de impacto da fadiga, escala de impacto da EM, escala de sono de Epworth e índice de qualidade de sono de Pittsburgh administrados pelo entrevistador B com reaplicação mensal do NFI-MS/BR durante mais 180 dias pelo entrevistador A. Foram avaliadas as propriedades psicométricas de qualidade dos dados, confiabilidade (consistência interna (coeficiente α de Cronbach), estabilidade teste-reteste (coeficiente de correlação intraclasse (CCI)) e concordância (teste Bland-Altman)), validade de constructo entre o NFI-MS/BR e os outros instrumentos (correlação de Spearman (rho), com hipóteses previamente definidas), sensibilidade, especificidade, responsividade, exame de dimensionalidade e calibração. A análise dos dados foi realizada utilizando os programas SPSS®, MedCalc® e RUMM®. Resultados: A adaptação transcultural gerou a versão NFI-MS/BR que manteve o número de itens, domínios, alocação dos itens, formato e padrões de respostas idêntico à versão original (NFI-MS). Não houve efeito ceiling e floor. O coeficiente α de Cronbach apresentou valores > 0,80 e < 0,90, demonstrando excelente consistência interna. A reprodutibilidade demonstrou excelente concordância na avaliação intra e interavaliador com CCI de 0,95 e 0,94 e diferença de média de -0,83 e 0,86, respectivamente. A validade de constructo (rho) foi confirmada na maioria das correlações. Os escores do NFI-MS/BR, durante as 7 entrevistas, foram similares (P = 0,868). O ponto de corte do NFI-MS/BR foi definido como ≥ 29,5 pontos indicativo de fadiga (86,8% de sensibilidade, 28,9% de 1- especificidade) (P < 0,001). Na análise Rasch, os itens foram ordenados, nenhuma dependência foi demonstrada sendo confirmadas a confiabilidade, qualidade dos dados e unidimensionalidade. O viés foi observado somente para a variável país e para um item, porém com pequena magnitude. Conclusão: O NFI-MS/BR é o primeiro instrumento específico e disponível no Brasil ajustado ao modelo de Rasch. Ele satisfaz os parâmetros clássicos e modernos de avaliação da fadiga sendo clinicamente viável, válido e confiável para avaliar indivíduos Brasileiros com EM.<br>Background: Fatigue is the most common and disabling symptom in multiple sclerosis (MS). However, its evaluation is limited by the failures and lack of psychometric instruments available. The questionnaire Neurological Fatigue Index for MS (NFI-MS) evaluates fatigue in MS specifically, and it was developed and validated in accordance with the recommended psychometric parameters. However, it is available only in British and Dutch cultural and idiomatic versions. Objective: the aim of this study was to cross-culturally adapt the NFI-MS questionnaire for the Portuguese language and Brazilian culture, and to assess its psychometric properties for measuring fatigue in subjects with MS. Methodology: The Brazilian version of the NFI-MS (NFI-MS/BR) was developed through forward-backward translation, expert review and field-testing on 30 MS subjects. For psychometric analysis, 210 MS subjects were assessed: the first 30 subjects were evaluated using the NFI-MS/BR by interviewers A and B on the same day and then retested seven days later by interviewer A. The other 180 MS subjects answered the following questionnaires: NFI-MS/BR, Fatigue Severity Scale, Modified Fatigue Impact Scale, Multiple Sclerosis Impact Scale-29 items, Epworth Sleep Scale and Pittsburgh Sleep Quality Index administered by interviewer B; with reapplication of the NFI-MS/BR monthly over 180 days by interviewer A. Evaluations were conducted on the psychometric properties of data quality; reliability (internal consistency, using Cronbach's α coefficient); test-retest reliability (intraclass correlation coefficient - ICC); agreement (Bland-Altman test); construct validity between the NFI-MS/BR and the other instruments (Spearman correlation (rho) with previously defined hypotheses); sensitivity; specificity; responsiveness; ordering threshold; local dependency; and unidimensionality. Data analysis was performed using SPSS®, MedCalc® and RUMM. Results: The cross-cultural adaptation generated a version of NFI-MS/BR that kept the number of items, domains, allocation of items, format and response patterns identical to the original version (NFI-MS). There was no ceiling nor floor effects. The Cronbach's α coefficient values were > 0.80 and <0.90, thus demonstrating excellent internal consistency. The reproducibility showed excellent intra and interobserver agreement, with ICC 0.95 and 0.94, and mean difference of -0.83 and 0.86, respectively. The construct validity (rho) was confirmed by the majority of the correlations. The scores from seven interviews using NFI-MS/BR were similar (P = 0.868). The cut-off point indicating fatigue was defined as ≥ 29.5 (86.8% sensitivity and 28.9% 1-specificity) (P < 0.001). In Rasch analysis, the item thresholds were ordered, no local dependency was demonstrated. The reliability, data quality and unidimensionality were confirmed. Statistical bias was observed only according to country and in one item, but with small magnitude. Conclusion: NFI-MS/BR is the first specific instrument available in Brazil that is adjusted to the Rasch model. It satisfies the modern standards of outcome measurement for fatigue and is clinically feasible, valid and reliable for assessing MS among Brazilians.
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Kaur, Inderpreet. "Delivering a remote exercise program embedded with behaviour change theory to persons with multiple sclerosis (MS): a randomised feasibility trial." Thesis, Kaur, Inderpreet (2021) Delivering a remote exercise program embedded with behaviour change theory to persons with multiple sclerosis (MS): a randomised feasibility trial. Masters by Research thesis, Murdoch University, 2021. https://researchrepository.murdoch.edu.au/id/eprint/61392/.
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Introduction: Multiple sclerosis (MS) is a chronic, autoimmune, and demyelinating disease of the central nervous system. Exercise has shown to be an effective treatment; however, those with MS often do not adhere to the recommended exercise guidelines. Our study investigated the feasibility of a remote exercise program embedded with behaviour change to increase exercise participation (primary outcome) and adherence among persons with MS and improve MS symptomatology and quality of life (secondary outcomes). Methods: Thirty-six adults with mild to moderate MS were stratified according to previous exercise levels and block-randomised into one of three groups: Control, General Exercisers (GE, who were not previously engaged in 30 or more minutes of moderate-intensity aerobic exercise 2+ days/week and 30 or more minutes of resistance training on 2+ days/week), and Advanced Exercisers (AE, who were previously engaged in 30 or more minutes of moderate-intensity aerobic exercise 2+ days/week and 30 or more minutes of resistance training on 2+ days/week). A four-month online exercise program including aerobic, resistance, balance, and flexibility training was delivered to GE and AE. We assessed four aspects of feasibility – process (recruitment), resources (monetary cost), management (staff time), and scientific (outcomes). At baseline, four months, and five months participants completed questionnaires to assess all outcomes. Participants logged exercise sessions using online exercise diaries and undertook video coaching calls. Clinical findings: GE (n=12) and control (n=12) participants increased their exercise participation, whereas AE (n=12) participants did not in 16 weeks (p =.06; GE, d=0.38, D=1.6 ; AE, d= -0.15, D=-2.9 ; CON, d=0.85, D=6; ‘D’ is change score). The adherence rate of coaching calls for the intervention was 92% for the GE and 83% for AE. Seventy-three per cent of GE and 38% of AE participants adhered to the prescribed exercise sessions. The total study intervention costs were AUD 1512.00, excluding projected personnel costs. The total personnel time required for the study was equal to 289 hours. Discussion: We found that a remote exercise program embedded with behaviour interventions is feasible and safe for persons with mild to moderate MS and helps increase their exercise participation and quality of life, but maybe less effective for those who are already active.
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Jamah, Kristina. "Hur effektivt är fingolimod vid behandling av multipel skleros?" Thesis, Linnéuniversitetet, Institutionen för naturvetenskap, NV, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-18559.
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Multipel skleros (MS) är en kronisk, neurologisk sjukdom som drabbar centrala nervsystemet (CNS). Sjukdomen är autoimmun där kroppens eget immunförsvar angriper nervvävnaden, framför allt myelin, och därefter uppstår en inflammatorisk reaktion. Nerverna i det centrala nervsystemet påverkar många olika funktioner och eftersom myelinet som omsluter nervfibrerna blir inflammerat på olika ställen, både i hjärnan och i ryggmärgen, uppkommer olika typer av symptom. Symptomen för MS kan skilja sig mycket från en individ till en annan, och från skov till skov. Om McDonald-kriterierna uppfylls, som bygger på att minst två separata CNS-lesioner skilda i rum och med minst en månads intervall påvisas utan en tydlig anledning, ställs diagnosen MS. Individer med MS producerar autoreaktiva T-celler som deltar i bildningen av inflammatoriska lesioner längs myelinskidan, men det finns även CNS-celler som gliaceller och astrocyter, som deltar i inflammationsprocessen. Vävnadstypen HLA-DR2 är förknippad med ökad risk att få MS. Den vanligaste och den milda formen av MS, skovvis förlöpande MS, bromsas med immunmodulerande läkemedel som interferon beta, fingolimod, m.fl. Syftet med det här litteraturarbetet var att utreda den kliniska effekten av fingolimod, den första orala behandlingen mot MS, på möjliga skador som förekommer på grund av MS. Studierna som granskades i detta arbete hämtades från Pubmed. Resultatet visar att fingolimod har klinisk effekt vid MS, men det behövs fler studier för att undersöka säkerhetsprofilen mer ingående. I en studie under två år reducerades den årliga skovfrekvensen från 0.4 till mindre än hälften av detta. I en annan två-årig studie, där fingolimod jämfördes med interferon-beta 1a, fanns det en signifikant större reduktion i den årliga skovfrekvensen i fingolimodgruppen (årlig skovfrekvens < 0,20) än i interferongruppen (årlig skovfrekvens 0,33). Majoriteten av patienterna (>70 %) förblev skovfria med fingolimodbehandlingen i båda studierna. Det fanns inga studier där fingolimod kombinerades med annan MS-behandling, vilket skulle vara intressant att se i framtiden.<br>Multiple sclerosis (MS) is a chronic neurological disease that affects the nerves within the central nervous system (CNS). The disease is autoimmune where the body's own immune system attacks nerve tissue, especially myelin, causing an inflammatory reaction. The nerves of the central nervous system serve many different functions and since the myelin surrounding the nerve fibers becomes inflamed at different places, both in the brain and the spinal cord, a variety of symptoms result. Symptoms of MS can differ greatly from one individual to another, as well as from relapse to relapse. If the McDonald criteria, which are based on at least two separate CNS lesions separated in space and at least one month apart demonstrated without a clear reason, are fulfilled a diagnosis of MS is set. Individuals with MS produce autoreactive T cells involved in the formation of inflammatory lesions along the myelin sheath, but CNS cells, glial cells and astrocytes, also participate in the inflammatory process. Tissue type HLA-DR2 is associated with increased risk of developing MS. The most common and mild form of MS, relapsing-remitting MS, can be slowed down with immunomodulatory drugs such as interferon beta, fingolimod, etc. The aim of this literature study was to investigate the clinical efficacy of fingolimod, the first oral therapy for MS, on the possible damage that occurs due to MS. The studies examined in this work were taken from Pubmed. The results demonstrate that fingolimod has clinical efficacy in MS, but more studies are needed to investigate the safety profile in more detail. In a study over two years the annualized relapse rate was reduced from 0.4 to less than half of this. In another two-year study in which fingolimod was compared with interferon-beta 1a, there was a significantly greater reduction in the annualized relapse rate in the fingolimod group (annualized relapse rate <0.20) than in interferon group (annualized relapse rate 0.33). The majority of patients (>70 %) remained relapse-free with fingolimod treatment in both studies. There were no studies that combined fingolimod with other MS treatments, which would be interesting to see in the future.
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Amini, Alikani Amineh, and Sofia Nygren. "Upplevelse, livskvalitet och stöd från sjuksköterskor : en litteraturstudie om fatigue hos personer med MS." Thesis, Högskolan i Gävle, Avdelningen för hälso- och vårdvetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-11823.
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Syfte: Var att öka förståelsen för upplevelsen av fatigue hos personer med MS och fatigues inverkan på livskvaliteten samt hur sjuksköterskan kan stödja och hjälpa personer med MS i vardagen. Metod: Litteraturstudie med deskriptiv design. Artiklarna (n=15) söktes fram i databaserna Medline via PubMed och Cinahl samt manuell sökning via referenslistor, sex stycken kvalitativa, åtta kvantitativa och en med en kombination av båda ansatser. Resultat: Det framkom att fatigue hos personer med MS var ett osynligt symtom som påverkade kroppen, led till begränsningar i vardagen, förvärrade andra symtom och led till sociala förändringar. Personer som led av fatigue hade lägre livskvalitet än den övriga befolkningen. Resultatet visade vilket stöd personer med MS önskade från sjuksköterskor. Personerna med MS hittade egna strategier för att hantera och lindra fatigue, ofta utan att ta hjälp av sjuksköterskor. Slutsats: Fatigue hos personer med MS var ett besvärligt symtom som påverkade deras vardag och sänkte deras livskvalitet. Eftersom fatigue var ett osynligt symtom behöver det uppmärksammas av sjuksköterskor. Mer forskning behövs i hur fatigue hos personer med MS ska behandlas samt hur sjuksköterskor på bästa sätt kan stödja personer med MS att hantera och lindra fatigue i deras vardag.<br>Purpose: was to increase understanding of the experience of fatigue in people with MS and fatigues impact on quality of life and how the nurse can support and help people with MS in their everyday life. Method: Literature review with a descriptive design. Articles (n=15) were retrieved from Medline via PubMed and Cinahl and manual reference lists, six qualitative, eight quantitative and one with a combination of both approaches. Findings: it was found that fatigue in people with MS was an invisible symptom, lead to limitations in their everyday life, increased other symptoms and lead to social changes. People suffering from fatigue had lower quality of life than the general population. The findings showed what kind of support people with MS wanted from nurses. People with MS found their own strategies to manage and relieve fatigue, often without help from nurses. Conclusion: Fatigue in people with MS was a troublesome symptom which affected their everyday life and lowered their quality of life. Since fatigue was an invisible symptom it should be approached by nurses. More research is needed about how fatigue in people with MS should be treated and how nurses can best support people with MS to manage and relieve fatigue in their everyday life.
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Norgren, Martin, and Johan Hägglund. "Upplevelser, påverkan på vardagen och egenvård : - En litteraturstudie om MS-relaterad fatigue." Thesis, Högskolan i Gävle, Avdelningen för hälso- och vårdvetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-13411.
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Syfte: Litteraturstudiens syfte var att beskriva upplevelsen av MS-relaterad fatigue, hur den påverkade vardagen och val av egenvårdsstrategier. Metod: Beskrivande litteraturstudie. Resultatdelen innehåller 15 st vetenskapliga artiklar, varav 8 st har en kvantitativ ansats, 5 st har en kvalitativ ansats och 2 st har båda ansatserna. Artiklarna söktes i databaserna PubMed och Cinahl och genom manuell sökning. Resultat: MS-relaterad fatigue var en unik och individuell upplevelse. Fatigue hade en multidimensionell och handikappande inverkan på vardagen, som berörde såväl fysiska, psykiska, sociala och kognitiva aspekter. Personer med MS hade utvecklat olika egenvårdsstragier för att minska, förebygga och dölja konsekvenserna av fatigue. Tre av artiklarna saknade en tillräcklig beskrivning av inklusions- och exklusionkriterier. Fyra artiklar saknade en adekvat beskrivning av bortfall. Slutsats: MS-relaterad fatigue bidrog till en försämring av fysiska, psykiska, sociala och kognitiva funktioner och stod i direkt relation till sämre livskvalitet. Befintliga egenvårdsstrategier kunde beskrivas utgå ifrån två olika teman: lindra och dölja konsekvenserna av fatigue. Levines bevarandemodell gav en omvårdnadsteoretisk förståelse av MS-relaterad fatigue som saknades i tidigare forskning.<br>Aim: The aim of this study was to describe the experience of MS-related fatigue, how it affected daily-living and different self-care strategies. Method: Descriptive literature study. The study contains 15 scientific papers, 8 had a quantitative approach, 5 had a qualitative approach and 2 included both approaches. The articles were found by using PubMed and Cinahl and by manual search. Results: MS-related fatigue was a unique and individual experience. Fatigue had a multidimensional and disabling impact on everyday life involving physical, psychological, social and cognitive aspects. People with MS had developed various self-care strategies to reduce, prevent and hide the effects of fatigue. Three of the articles lacked a sufficient description of inclusion and exclusion criteria. Four articles lacked an adequate description of the discontinuity of participation. Conclusion: MS-related fatigue contributed to a deterioration of the physical, psychological, social and cognitive functions and was directly related to lower quality of life. Existing self-care strategies could be described in two themes: to ease and hide the effects of fatigue. Levine's conservation model yielded a theoretical understanding of MS-related fatigue. Previous research did not incorporate a nursing theoretical understanding of MS-related fatigue.
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Kithcart, Aaron. "Macrophage Migration Inhibitory Factor: A Key Mediator of Inflammatory Disease." The Ohio State University, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=osu1244077146.
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Viar, Kenneth E. II. "Role of SARM1 in Chronic Immune-Mediated Central Nervous System Inflammation." VCU Scholars Compass, 2019. https://scholarscompass.vcu.edu/etd/5819.
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SARM1 is an injury-induced nicotinamide adenine dinucleotide nucleosidase (NADase) that was previously shown to promote axonal degeneration in response to traumatic, toxic, and excitotoxic stressors. This raises the question of whether a SARM1-dependent program of axonal degeneration is central to a common pathway contributing to disease burden in neurological disorders. The degree to and mechanism by which SARM1 inactivation decreases the pathophysiology of such disorders is of interest to establish the rationale to pursue SARM1 as a therapeutic target. In this study, we compare the course and pathology of experimental autoimmune encephalomyelitis (EAE) in Sarm1-knockout (KO) mice and wild-type littermates to test the contribution of SARM1-dependent axonal degeneration specifically in the context of chronic, immune-mediated central nervous system (CNS) inflammation. The question of whether SARM1 loss in Sarm1-KO mice would inhibit, promote, or have a negligible impact on EAE-induced axonal degeneration and more broadly CNS inflammation was explored using a variety of analyses: quantification of clinical score in a chronic EAE model, CNS immune infiltrate profile, axon initial segment morphology in layer V cortical neurons, axonal transport disruption and transection in the lumbar spinal cord. Additionally, we have proposed a method for detecting SARM1 activation in situusing a novel SARM1-mCitrine bimolecular fluorescence complementation (BiFC) technique. Successful implementation of such a molecular tool would allow for a detailed, mechanistic approach to enhance our understanding of upstream intracellular signals that trigger SARM1 activation.
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Sundin-Röstberg, Lotta, and Åse Zachrisson. "Multipel Skleros och Graviditet : Omvårdnad och stöd till kvinnor med MS före, under och efter graviditet." Thesis, Högskolan i Gävle, Avdelningen för hälso- och vårdvetenskap, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-27459.
Full textAbstract:
Syfte: Var att beskriva MS-patienters erfarenheter före, under och efter graviditet. Hur MS-sjuksköterskan kan stötta och vägleda MS-patienter i frågor som kan uppstå före, under och efter graviditeten utifrån evidensbaserad kunskap. Vidare granskades den metodologiska aspekten gällande urvalet/urvalskriterierna i litteraturstudiens utvalda artiklar. Metod: Litteraturstudien hade en beskrivande design. Artikelsökning gjordes i databaserna Pubmed, PsycInfo, och Cinahl samt manuell sökning utifrån de granskade artiklarna i litteraturstudien. Artiklarna (n=18) var 1 antal kvalitativa, och 17 antal kvantitativa. Resultat: Kvinnorna vågade ofta inte ta upp ämnet graviditet, behandling, amning och sin sjukdom med sin läkare. Studier visade att kvinnor som fick någon form av beslutsstöd fick ökad kunskap om graviditet vid diagnosen MS och en ökad självsäkerhet angående sitt beslut att vilja starta en familj jämfört med kvinnor som inte fick detta stöd. Det var viktigt att vara öppen och diskutera fördelar och nackdelar med den behandling som kvinnan har och att missfall och defekter hos ett barn även kan ske i en “normal” graviditet. Slutsats: MS-patienten har samma möjlighet att bli gravid och genomgå en normal graviditet och förlossning som frisk kvinna. Är patienten välinformerad om sin sjukdom och frågor rörande sin sjukdom ökar chansen för en lyckad tid före, under och efter graviditeten. Riktlinjer behövs utarbetas för kvinnor med MS inför graviditet. MS-sjuksköterskan behöver ha en god medicinsk kunskap om sjukdomen och de olika behandlingsalternativ som finns för att kunna ge en god omvårdnad och stöd till kvinnan under denna period.<br>Aim: Was to describe MS patients' experiences before, during and after pregnancy. How the MS nurse can support and guide MS patients in issues that may occur before, during and after pregnancy based on evidence-based knowledge. Furthermore, the methodological aspect of the selection / selection criteria in the selected articles of this literature study was examined. Method: Literature study with descriptive design. Articles (n=18) were retrieved from Pubmed, PsycInfo, and Cinahl, as well as manual search based on the reviewed articles in the literature study. The items (n = 18) were 1 number of qualitative, and 17 number of quantitative. Result: Women did not often dare to address the subject of pregnancy, treatment, breastfeeding and their illness with their doctor. Studies showed that women receiving some form of decision aid increased their knowledge of pregnancy and got an increased self-esteem regarding their decision to start a family compared with women who did not receive this support. It is important to be open and discuss the pros and cons of the treatment and that miscarriage and birth defects also can occur in a "normal" pregnancy. Conclusion: The MS patient has the same opportunity to conceive and undergo a normal pregnancy and childbirth as a healthy woman. If the patient is well informed about her illness and questions about her illness, the chance of a successful time before, during and after pregnancy increases. Guidelines are needed for women with MS prior to pregnancy. The MS nurse needs a good medical knowledge of the disease and the different treatment options available to provide good care and support for the woman during this period.
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Dwyer, Michael G. "Development and application of novel algorithms for quantitative analysis of magnetic resonance imaging in multiple sclerosis." Thesis, University of Bradford, 2013. http://hdl.handle.net/10454/6298.
Full textAbstract:
This document is a critical synopsis of prior work by Michael Dwyer submitted in support of a PhD by published work. The selected work is focused on the application of quantitative magnet resonance imaging (MRI) analysis techniques to the study of multiple sclerosis (MS). MS is a debilitating disease with a multi-factorial pathology, progression, and clinical presentation. Its most salient feature is focal inflammatory lesions, but it also includes significant parenchymal atrophy and microstructural damage. As a powerful tool for in vivo investigation of tissue properties, MRI can provide important clinical and scientific information regarding these various aspects of the disease, but precise, accurate quantitative analysis techniques are needed to detect subtle changes and to cope with the vast amount of data produced in an MRI session. To address this, eight new techniques were developed by Michael Dwyer and his co-workers to better elucidate focal, atrophic, and occult/"invisible" pathology. These included: a method to better evaluate errors in lesion identification; a method to quantify differences in lesion distribution between scanner strengths; a method to measure optic nerve atrophy; a more precise method to quantify tissue-specific atrophy; a method sensitive to dynamic myelin changes; and a method to quantify iron in specific brain structures. Taken together, these new techniques are complementary and improve the ability of clinicians and researchers to reliably assess various key elements of MS pathology in vivo.