International journal of MS care最新文献

{"title":"Cooling Vests Improve 6-Minute Walk Test Performance in People With Multiple Sclerosis: A Randomized Crossover Trial.","authors":"Herbert Karpatkin, Evan T Cohen, Jaya Rachwani, Sean Riva, Sandon Stevens, Kaitlin Russo, Winnie Yu","doi":"10.7224/1537-2073.2024-021","DOIUrl":"https://doi.org/10.7224/1537-2073.2024-021","url":null,"abstract":"<p><strong>Background: </strong>Walking in people with multiple sclerosis (MS) is limited by thermosensitivity, as prolonged activity raises body temperature. Administering a cooling intervention prior to physical activity can improve function; however, there are few data regarding the effect of cooling on walking. The purpose of this study was to compare walking distance in uncooled (control) and cooled conditions in a sample of people with MS. We hypothesized that participants would walk greater distances on a timed walking test after administration of a cooling intervention compared with a condition in which no cooling was administered.</p><p><strong>Methods: </strong>A randomized crossover design was used. Fifteen participants (median Expanded Disability Status Scale score 4, IQR 1.5, range 3-5) underwent a 6-minute walk test (6MWT) in both cooled (CC) and uncooled (UC) conditions in a randomized test order. In CC, participants wore a cooling vest for 30 minutes prior to performing the 6MWT. In UC, participants performed the 6MWT without precooling. Participants returned 1 to 2 weeks later and repeated the 6MWT in the opposite condition. The total and per-minute distances during the 6MWTs were collected.</p><p><strong>Results: </strong>Participants walked longer distances during the 6MWT in the CC compared with the UC. Post hoc analysis of per-minute distances showed that participants accumulated greater walking distances in minutes 5 and 6 in the CC compared with the UC.</p><p><strong>Conclusions: </strong>Precooling with a cooling vest had a significant impact on 6MWT performance in this sample of people with MS. The use of a cooling vest should be considered in walking programs for people with MS.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 3","pages":"246-250"},"PeriodicalIF":0.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Migraine in Multiple Sclerosis: Underlying Mechanisms, Shared Symptoms, and Approaches to Management.","authors":"Pavika Thevar, Helmut Butzkueven, Jason Ray, Alissandra McIlroy, Elspeth Hutton, Rubina Alpitsis","doi":"10.7224/1537-2073.2024-056","DOIUrl":"https://doi.org/10.7224/1537-2073.2024-056","url":null,"abstract":"<p><strong>Background: </strong>Migraine affects approximately 50% of people with relapsing-remitting multiple sclerosis (MS). People with MS and migraine also have greater symptom burden and an increased risk of relapse. Understanding the pathophysiology, symptoms, and approaches to migraine treatment is critical to improving outcomes for this population.</p><p><strong>Methods: </strong>A narrative review was conducted to investigate the pathobiological mechanisms of comorbid migraine in MS, the impact of psychological and cognitive symptoms, and the available treatment options.</p><p><strong>Results: </strong>The review identified potential reciprocal mechanisms in comorbid migraine and MS, including recurring MS-related inflammation, brainstem lesions, neuroinflammation in migraine, and the disruption of the blood-brain barrier. Shared demographic and endocrine risk factors for MS and migraine were detailed, along with the effect of MS treatments on worsening preexisting migraine. Both disorders were associated with subjective and objective cognitive deficits, particularly affecting processing speed, attention, and executive functions, as well as higher rates of depression and anxiety compared with the general population. In MS, preventive migraine treatments were underprescribed. Selection of prophylactics should include consideration of comorbid symptoms, such as depression and fatigue. Evidence also supports the potential efficacy of behavioral interventions for migraine prevention.</p><p><strong>Conclusions: </strong>While much remains to be understood, recognizing the comorbid symptoms and appropriate migraine treatments for people with relapsing-remitting MS can guide clinical decision-making and promote quality of life. Further research is needed to evaluate the efficacy of such therapies for people with MS.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 3","pages":"236-245"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unspoken Challenges: Sexual Health in Sexual and Gender Minority People With Multiple Sclerosis.","authors":"Alexandra Balshi, Maya Behn, Tamara B Kaplan","doi":"10.7224/1537-2073.2024-090","DOIUrl":"https://doi.org/10.7224/1537-2073.2024-090","url":null,"abstract":"<p><p>Sexual health is an integral part of overall well-being, encompassing emotional, psychological, and physical aspects that profoundly influence quality of life. Despite the prevalence of sexual dysfunction (SD) among people with multiple sclerosis (MS), it is too frequently underreported and undertreated. Sexual and gender minority (SGM) people with MS, in particular, may face stigma, discrimination, and clinician hesitancy that can bar access to necessary sexual health care. Recognizing SGM identity can help clinicians deliver more inclusive general and sexual health care, including but not limited to family planning and gender-affirming care. The 8 Ps model can aid in taking a nonjudgmental sexual history that allows for recognition of sexual dysfunction regardless of identity.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 3","pages":"229-235"},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of Aerobic Exercise in People With Advanced Multiple Sclerosis: Characterizing Acute Responses to Inform Exercise Prescription.","authors":"Thomas Edwards, Arthur Chaves, Zain Awadia, Julia Ludgate, Aidan Peters, Lisa A S Walker, Lara A Pilutti","doi":"10.7224/1537-2073.2024-063","DOIUrl":"https://doi.org/10.7224/1537-2073.2024-063","url":null,"abstract":"<p><strong>Background: </strong>The role of exercise for people with advanced multiple sclerosis (MS) is largely unknown. Characterizing acute exercise responses could inform exercise interventions.</p><p><strong>Methods: </strong>Eighteen people with advanced MS (Expanded Disability Status Scale score of 7.0-8.0) performed three 15-minute bouts of submaximal exercise using an arm cycle ergometer (ACE), a recumbent stepper (RS), and a functional electrical stimulation (FES) cycle. Change in neurological function, symptoms of fatigue and pain, affect, and adverse events (AEs) were recorded.</p><p><strong>Results: </strong>Participants demonstrated increased sensory impairment immediately after completing exercise compared with before engaging in exercise (<i>P</i> = .03), as well as 30 minutes post exercise (<i>P</i> = .005). Participants' performance on the Stroop Color and Word Test improved at 30 minutes after exercise compared with before exercise (<i>P</i> = .008). Participants reported elevated pain immediately after (<i>P</i> = .02) and 24 hours after (<i>P = .</i>003) exercise compared with pre-exercise levels. Compared with how they felt immediately after exercise, participants reported feeling better at 30 minutes (<i>P <</i> .001) and 24 hours (<i>P = .</i>01) after exercise. Participants reported more fatigue symptoms with ACE compared with FES, and more pain symptoms with ACE and RS compared with FES (all <i>P</i> > .02). Participants reported feeling better in response to FES compared with ACE (<i>P = .</i>002). No serious AEs were reported, and there were no differences in the number of AEs across modalities.</p><p><strong>Conclusions: </strong>This study demonstrated transient changes in sensory function and increased pain with acute aerobic exercise. Improved cognitive performance, specifically selective attention and executive control, and an overall positive experience were noted in response to exercise. A greater symptomatic response and less favorable experience may be expected with ACE or RS compared with FES exercise. Results of this study can inform exercise prescriptions in advanced MS.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 3","pages":"218-228"},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of Word-Finding Difficulties in Multiple Sclerosis: A Qualitative Interview Study.","authors":"Charlotta Saldert, Carla Giocondi, Freddie Van Eijsden, Francesca Longoni","doi":"10.7224/1537-2073.2024-069","DOIUrl":"https://doi.org/10.7224/1537-2073.2024-069","url":null,"abstract":"<p><p>Abstract.</p><p><strong>Background: </strong>The ability to communicate may be impaired in people with multiple sclerosis (MS), as both speech and language may be affected. Although word-finding difficulty is a common impairment, little is known about how this affects everyday life for people with MS.</p><p><strong>Methods: </strong>In this qualitative study, word-finding difficulty was explored via interviews with 18 individuals with MS. The results were reviewed via qualitative content analysis.</p><p><strong>Results: </strong>In the analysis, 3 overarching themes emerged: (1) word-finding difficulty affects everyday life; (2) word-finding difficulties may be handled in various ways; and (3) there are certain factors that can facilitate or hinder word-finding. The participants described different degrees of difficulty with word-finding and how words may be substituted in an unpredictable way. This often affected their ability to participate in everyday communication. Despite using various strategies, for example, using other words and involving the conversation partner in the word search, many described themselves as being changed as communicators. Factors that facilitated or hindered word-finding included contextual factors, such as stressful situations and sensory processing load, and the impact of fatigue, emotions, and conversational partners' behaviors.</p><p><strong>Conclusions: </strong>Even minor word-finding difficulty may impact an individual's ability to participate in everyday communication. Knowing what may help or hinder communication is important for both people with MS and their communication partners.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 3","pages":"210-217"},"PeriodicalIF":0.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of Cognition, Fatigue, and Mental Health Screening at a Canadian Multiple Sclerosis Center: A Quality Improvement Initiative.","authors":"Tamanna Islam, Jordan D Pumphrey, Marjorie Bowman, Jason A Berard, Reece Bearnes, Tammy Pham, Lisa A S Walker","doi":"10.7224/1537-2073.2024-096","DOIUrl":"https://doi.org/10.7224/1537-2073.2024-096","url":null,"abstract":"<p><p>Abstract.</p><p><strong>Background: </strong>Mental health concerns, cognitive impairment, and fatigue are prevalent among Canadians with multiple sclerosis (MS), yet many neurology clinics are not equipped to adequately address these concerns. In this quality improvement initiative, low-burden systems were implemented at an MS clinic with the aim of improving the identification of these invisible symptoms among people with MS.</p><p><strong>Methods: </strong>Self-report questionnaires assessing anxiety, depression, and fatigue were electronically administered to patients prior to clinic appointments. When moderate mental health symptoms were reported, clinicians were alerted by a best practice advisory and directed to provide the patient with a list of local low- and no-cost mental health services. An MS-sensitive cognitive task was also administered via a tablet upon check-in to patients meeting with the physician assistant (PA). Data were collected from appointment notes over 10 clinic days before and after implementation.</p><p><strong>Results: </strong>From pre- to post implementation, the proportion of patients who received formal mental health screening increased from 0% to 54.55%, and the proportion of patients with mental health concerns who were offered resources increased from 23.53% to 47.83%. The proportion of patients who received formal fatigue screening increased from 0% to 22.46%. The rate of cognitive testing in visits with the PA increased from 33.33% to 85.11%.</p><p><strong>Conclusions: </strong>This initiative improved mental health, cognitive, and fatigue screening and established a foundation for ongoing quality improvement initiatives to better meet best practice recommendations for comprehensive MS care.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 3","pages":"195-199"},"PeriodicalIF":0.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disaster Preparation for People With Multiple Sclerosis: A Scoping Review of Resources.","authors":"Jocelyn Tan, Claudia H Marck, Pamela Martin Lynch, Petra Skeffington, Diana Walker, Lisa Gibbs, Yvonne C Learmonth","doi":"10.7224/1537-2073.2024-066","DOIUrl":"https://doi.org/10.7224/1537-2073.2024-066","url":null,"abstract":"<p><strong>Background: </strong>People with multiple sclerosis (MS) have unique needs during a disaster, increasing preparation requirements. The content and patient-level suitability of disaster preparation tools is unknown. This scoping review aimed to determine the range and content of disaster preparation resources that are freely available online and suitable to assist people with MS.</p><p><strong>Methods: </strong>Resources were identified via the Turning Research Into Practice medical database, Google, and disability-related websites. The included resources were disability specific and have been published since 2017. Resources were inductively analyzed and presented according to the target audience and themes. Findings were compared with stakeholder preferences.</p><p><strong>Results: </strong>Fifty-nine resources were identified, targeting carers (27.1%), health care professionals (10.2%), and people with disabilities (89.8%). Resource content themes were advanced planning, informing others, practical preparations, and review. Consumer involvement was reported in 2 resources. Stakeholder preferences for disaster preparedness content were not well reflected in the resources.</p><p><strong>Conclusions: </strong>The review identified online disaster preparedness resources suitable for people with MS and highlighted important gaps. More inclusive resources can be created with consumer involvement in design. Identified themes inform professionals about resources to recommend to patients based on their needs. Health care professionals can aid preparation by addressing resource gaps, particularly regarding health condition management.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 3","pages":"186-194"},"PeriodicalIF":0.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Designing Well-Being Intervention Trials for People With Progressive Multiple Sclerosis: The Importance of Understanding Usual Care Comparators.","authors":"Marcia Finlayson, Silvia Poli, Federico Bozzoli, Giampaolo Brichetto, Lars Bø, Isolde Martina Busch, Ulrik Dalgas, Nikos Evangelou, Amanda Farrin, Jennifer Freeman, Helena Jidborg, Daphne Kos, Claudia H Marck, Daniel Ontaneda, Jessica Podda, Michela Rimondini, Polly Swain, Emma Tallantyre, Lauren A Taylor, Roshan das Nair","doi":"10.7224/1537-2073.2024-099","DOIUrl":"https://doi.org/10.7224/1537-2073.2024-099","url":null,"abstract":"<p><p>Well-being captures an individual's capacity to lead a meaningful and engaged life. Interventions to address well-being go beyond managing symptoms or supporting daily activity performance. Designing trials to evaluate the effectiveness of such well-being interventions can be challenging. One such challenge is determining what the comparator or control arm should be. Several trials of complex interventions use usual care as a comparator, but this can be particularly challenging when planning trials across multiple countries and health care systems. Therefore, trial design decisions must be informed by a good understanding of what constitutes usual or routine well-being interventions across locations. Our international, multidisciplinary team's efforts to develop this understanding across our 8 countries found that efforts to support the well-being of people with progressive multiple sclerosis vary widely. This variability emphasizes the importance of having a consistent way to collect data and report on the components of usual well-being care to inform trial design.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 Suppl 1","pages":"T27-T31"},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Updated Assessment of Patient Knowledge in Pregnancy and Multiple Sclerosis.","authors":"Kristen Veal, Vivian Chen, Suma Shah","doi":"10.7224/1537-2073.2024-011","DOIUrl":"https://doi.org/10.7224/1537-2073.2024-011","url":null,"abstract":"<p><p>Abstract.</p><p><strong>Background: </strong>Multiple sclerosis (MS) is more prevalent in women and is frequently diagnosed during their childbearing years. Prior inquiry into patient knowledge regarding family planning has revealed that patients feel inadequately informed about topics surrounding pregnancy.</p><p><strong>Methods: </strong>We designed and implemented a 13-question survey to assess patient comprehension surrounding pregnancy and treatment options at the Duke Comprehensive MS Center.</p><p><strong>Results: </strong>Forty-four surveys were returned, with responses from 1 survey not included in the analysis due to most of the questions being left unanswered. The average patient age was 44 years. Thirteen of the 43 participants believed that their risk of relapse would increase during pregnancy, and 4 participants believed that their risk of relapse did not increase after pregnancy. Two patients reported that they had been told they could not have children due to their diagnosis of MS. Twelve of 37 participants reported that they did not have as many children as they would like.</p><p><strong>Conclusions: </strong>The results of this survey highlight persistent gaps in knowledge regarding the ability to have children, risk of relapse throughout pregnancy and the postpartum period, and treatment options for women of childbearing age with MS. It was also noted that of the 11 participants who indicated that they wanted to have more children in the future, 4 were on disease-modifying therapies that are recommended to be discontinued once pregnant and 1 was on a therapy that is contraindicated in pregnancy. Addressing this gap would require up-to-date and evidence-based discussions about pregnancy in MS beginning at the initial visit and at each subsequent visit to allow individualization of the treatment plan.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 3","pages":"182-185"},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumefactive Demyelination in Older Adults: Diagnosis and Misdiagnosis.","authors":"Carla De Pasquale, Michael H Barnett, Todd A Hardy","doi":"10.7224/1537-2073.2024-009","DOIUrl":"https://doi.org/10.7224/1537-2073.2024-009","url":null,"abstract":"<p><p>Tumefactive demyelination (TD) is often misdiagnosed as central nervous system malignancy. We report on 4 patients 65 years or older with TD whose initial misdiagnosis led to biopsy or resection. This series draws attention to TD as an uncommon cause of cerebral lesions in older patients. We highlight the importance of MRI and ancillary tests to diagnose TD and avoid invasive investigations.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 3","pages":"176-181"},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}