MSWA2016302 Network Magazine Spring 16 v4

Round-up of research
and other items of interest
Sue Shapland RN, BN
Here we bring you some interesting research updates from
various sites around the world.
Does the month you were born affect your risk of
developing MS?
A large study which included a very detailed survey was
undertaken to determine whether there is a pattern to birth
month for people with multiple sclerosis.
Data from more than 21,000 people with MS in the UK were
included and the study found that people diagnosed with MS
are more likely than average to have been born in April, and
less likely than average to have been born in November.
The results of the study suggest that environmental factors
very early in life contribute to the risk of MS. One of these
factors could be low sunlight exposure during winter
pregnancies, leading to low maternal vitamin D levels which in
some way increase the risk of developing MS later in life. Other
factors such as the mother’s exposure to seasonal infections or
seasonal differences in diet could also play a part.
Comment by authors: Birth month is only one of a number
of environmental factors that could influence the risk of
developing MS. Others include smoking and exposure to
infections, especially Epstein-Barr virus which causes
glandular fever.
Rodríguez Cruz PM, Matthews L, Boggild M, et al.
Are headaches more common during a relapse?
Headaches are more common in
people with MS and this study
investigated if headaches were
more likely to occur during a
relapse than remission.
This study in Iran compared the
reports from 57 people with
RRMS and 57 people without a
neurological condition (controls).
People with MS were questioned during a relapse and again
three months later. It was found that headaches were more
common during a relapse, particularly migraines. However,
headaches were also more common in people with MS
during remission, when compared to the general population.
Nearly 50% of people with MS having a relapse also
experienced a headache compared with 38.6% in remission
and 27.7% in the control group. The most common type of
headache to experience during a relapse was a migraine,
followed by tension headache.
Headaches during a relapse were reported to be severe
and described as compressing. People who had been
diagnosed with MS in the last three years were more likely
to experience a headache during relapse than those who had
been diagnosed for longer.
Togha M, Abbasi Khoshsirat N, Moghadasi AN, et al.
Could Pilates have cognitive
benefits as well as physical?
In the past, people with MS
were advised to avoid exercise
especially activities that might
be tiring. However, a number of
studies have shown that regular,
moderate exercise is a good thing.
Pilates is one of many options
available to stay active.
This study included 20 people with MS, split into two
groups. The first adhered to clinical Pilates and the second a
traditional exercise program for eight weeks.
The study found that both clinical programs improved
performance on some physical tests. Those in the Pilates
group had significant improvements in balance, fatigue
and tiredness and they had greater improvements in their
cognitive symptoms and quality of life when compared to the
traditional exercise group participants.
Küçük F, Kara B, Poyraz EÇ, Idiman. J Phys Ther Sci. 2016
Mar;28(3):761-8. Epub 2016 Mar 31.
Some forms of MS may be hereditary
After many years of saying that MS is not passed down the
generations, new research is now saying the opposite.
Researchers from Canada, led by Prof. Carles Vilariño-Güell,
report they have proven that MS can result from a single genetic
mutation on a gene called NR1H3. This they say produces a
protein that acts as an ‘on-off switch’ for other genes.
Just one in 1,000 people with MS have this specific mutation
according to the researchers. However, the finding uncovers the
biological pathway that leads to the rapidly progressive form of
MS, which accounts for 15% of people with the disease.
The researchers used blood samples from 4,400 people
with MS and 8,600 blood relatives as part of a 20-year
project funded by the MS Society of Canada and the Multiple
Sclerosis Scientific Research Foundation.
They found the mutation in two Canadian families in which
several members lived with a rapidly progressive type of the
disease. In these families, two-thirds of the people with the
genetic mutation developed MS.
Childhood obesity linked to higher risk of MS
A collaboration between researchers from Canada and the
UK has found a causal relationship between obesity and the
risk of developing multiple sclerosis. Several observational
studies suggest that obesity (measured by Body Mass Index
or BMI) in a person’s earlier stages of life is associated
with an increased risk of developing MS. The research also
suggested a relationship between the decrease in vitamin
D levels as a person’s weight increases as a possible
mechanism for the increased risk.
The Progressive MS Alliance Updates
More than 2.3 million people live with MS worldwide; over
one million have progressive MS. Up to 15% are diagnosed
with primary progressive MS. Whilst there have been
advances in understanding other forms of MS, progressive
MS remains difficult to understand and treat.
The International Alliance was set up to focus research
efforts on progressive MS; Australia is represented
through MSRA. Initial funding was allocated for 22 projects
designed to improve understanding of genetic and biological
processes, repurpose existing drugs and speed up clinical
trials. These one to two year research projects began in
2015, and focus on six areas:
• Clinical trials and outcome measures
• Biomarkers of progression
• Gene studies
• Rehabilitation trials
• Underlying pathology of progression
• Developing new disease models
Cancer risk associated with Mitoxantrone
Mitoxantrone is an anti-cancer drug that was sometimes
used to treat active MS. Dosage was limited as it is known
to cause damage to the heart muscles. It is already known
that there is an associated increased risk of cancer. This
study followed a group of German patients for a number
of years. They reported that 5% of people or 1 in 20 got
cancer. Whilst life is associated with a cancer risk, this
appears high and is one of the reasons that use of this agent
has dwindled.
Conclusion: While the overall incidence of malignancies
was only mildly increased, the risk of leukaemia and
colorectal cancer was heightened. If confirmed, post-therapy
colonoscopy could become advisable.
Buttmann M, Seuffert L, Mäder U, Toyka KV. Malignancies
after mitoxantrone for multiple sclerosis: A retrospective
cohort study. Neurology. 2016 Jun 7;86(23):2203-7.
Websites of interest:
MS in children online resources from MSIF
Here you can find information about MS in children and
download a parent’s guide.
Visit: msif.org/about-ms/childhood-ms/
MStranslate
This Australian website seeks to bring together “the wealth
of information on MS in a way that makes it accessible to
every element of the community”.
There are a range of links and summaries of various
research studies including those looking into lifestyle
modification e.g. the multiple benefits of exercise.
They collaborate with a range of Australian researchers
including Professor George Jelinek, head of the
Neuroepidemiology Unit at the University of Melbourne.
Visit: mstranslate.com.au
Read more at:
ms.asn.au/researchupdate
8 Spring 2016 The MS Society of South Australia & Northern Territory The MS Society of South Australia & Northern Territory Spring 2016 9