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MSWA Bulletin Magazine Summer 2022

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Keeping your cool this summer | Welcome Melanie Kiely CEO | MSWA Stationary Cycle results | Pain and pain management series: Part 3

RESEARCH Among the six

RESEARCH Among the six studies that matched their eligibility criteria, two were clinical trials in which participants were randomly assigned to either vitamin D or placebo, and the remaining four were prospective studies conducted over time. All selected studies indicated some positive association between vitamin D supplementation and mental health, but only in particular subcategories of mental health. One study indicated a lower risk of depression with vitamin D. However, after adjusting for influencing factors, such as smoking, diet, and physical activity, the association was no longer statistically significant. Four studies supported a positive effect of vitamin D supplementation on the mental health of MS patients, including the study considered the highest quality. “Based on this review, we concluded that there may be a positive effect of vitamin D supplementation,” the researchers wrote. “Such a positive effect was found in all the studies analyzing quality of life, as well as in one study that analyzed depressive symptoms.” Taking into consideration that “vitamin D deficiency is common in MS patients, and the potential positive influence of supplementation on the quality of life in this group,” the researchers suggest that MS patients should receive regular vitamin D supplementation. FROM SCIENCE DAILY Read more at: Parkinson’s protein blueprint could help fast-track new treatments; Walter and Eliza Hall Institute, December 23, 2021. Researchers have solved a decadelong mystery about a critical protein linked to Parkinson's disease that could help to fast-track treatments for the incurable disease. The research has produced a 'live action' view of the protein, called PINK1, in exquisite molecular detail. The discovery explains how the protein is activated in the cell, where it is responsible for initiating the removal and replacement of damaged mitochondria. When the protein is not working correctly, it can starve brain cells of energy, causing them to malfunction and – in the long term – die, as happens to dopamine-producing cells in Parkinson's disease. The discovery is the culmination of a project spanning eight years and provides the first detailed blueprint for the discovery and development of therapeutic agents that could help to slow or even stop the progression of Parkinson's disease. PhD student and first author Zhong Yan Gan said the research provided an unprecedented view of a protein called PINK1, known to play a critical role in early onset Parkinson's disease. "Many papers from laboratories around the world – including ours – have captured snapshots of the PINK1 protein. However, the difference in these snapshots has in some ways fuelled confusion about the protein and its structure," Mr Gan said. Professor Komander said his lab's discovery paved the way for developing therapeutic agents that 'switch on' PINK1 to treat Parkinson's disease. "There are currently no disease-modifying drugs available for Parkinson's disease – that is no drugs that can slow progression of the disease or halt its development," Professor Komander said. Malfunctions in PINK1, or other parts of the pathway that control mitochondrial repair, is thought to be a key feature in certain cases of Parkinson's disease. However, this information is particularly relevant for a subset of young people who develop Parkinson's in their 20s, 30s and 40s due to hereditary mutations in PINK1. The discovery would lead to new opportunities to exploit this pathway for Parkinson's disease therapies. "Biotech and pharmaceutical companies are already looking at this protein and this pathway as a therapeutic target for Parkinson's disease, but they have been flying a bit blind. I think they'll be really excited to see this incredible new structural information that our team has been able to produce using cryo-EM. I'm really proud of this work and where it may lead," he said. Stroke may be triggered by anger, emotional upset and heavy physical exertion; National University of Ireland Galway, December 2, 2021. A global study into causes of stroke found one in 11 survivors experienced a period of anger or upset in the one hour leading up to it. One in 20 patients had engaged in heavy physical exertion. The suspected triggers have been identified as part of the global INTERSTROKE study, which analysed 13,462 cases of acute stroke, involving patients with a range of ethnic backgrounds in 32 countries. 10

Stroke is a leading global cause of death or disability. The research analysed patterns in patients who suffered ischemic stroke – the most common type of stroke, which occurs when a blood clot blocks or narrows an artery leading to the brain, and also intracerebral haemorrhage – which is less common and involves bleeding within the brain tissue itself. The study looked at two separate triggers. “Our research found that anger or emotional upset was linked to an approximately 30% increase in risk of stroke during one hour after an episode – with a greater increase if the patient did not have a history of depression. The odds were also greater for those with a lower level of education”. "The study also concluded that there was no increase with exposure to both triggers of anger and heavy physical exertion." The global INTERSTROKE study was co-led by Professor Martin O'Donnell, Professor of Neurovascular Medicine at NUI Galway, and Consultant Stroke Physician at Galway University Hospitals, in collaboration with Prof Salim Yusuf of the Population Health Research Institute of McMaster University and Hamilton Health Sciences, Canada. "Some of the best ways to prevent stroke are to maintain a healthy lifestyle, treat high blood pressure and not to smoke, but our research also shows other events such as an episode of anger or upset or a period of heavy physical exertion independently increase the shortterm risk." Prof O'Donnell said. "We would emphasise that a brief episode of heavy physical exertion is different to getting regular physical activity, which reduces the longterm risk of stroke." Breakthrough in understanding motor neuron disease, Trinity College Dublin, November 29, 2021. Researchers at Trinity College Dublin have made a major discovery in understanding motor neuron disease (MND). The research team has found that MND has 4 distinct patterns of changes in electrical signals that can be identified using EEG (electroencephalography). This breakthrough will be extremely valuable in identifying patients for clinical trials and will assist in finding new treatments for this devastating disease. The study has been published online today (Monday, 22nd November 2021) in the journal Brain. MND is a devastating condition which causes increasing physical disability and ultimately death within an average of two to three years. There is currently no effective treatment. While trials of new drugs are being undertaken, MND is known to be very heterogeneous (very diverse / dissimilar) with different patterns of disability and life expectancy. Predicting in advance the pattern of disability and life expectancy is one of the major challenges in designing modern clinical trials. The world class electrical signal analysis research developed within Trinity College discovered different patterns of brain network disruption reflect the underlying disease process. The Trinity researchers have now shown that these patterns of brain network disruptions in MND cluster into 4 distinct subtypes that are predictive of how the disease progresses. The team's findings move the Trinity researchers one step closer to building better and more effective treatments for different sub-categories of the disease. The work was performed by Mr Stefan Dukic, a PhD student within the Academic Unit of Neurology at Trinity, under the supervision of Dr Bahman Nasseroleslami, Fr Tony Coote Assistant Professor in Neuroelectric Signal Analysis. Dr Bahman Nasseroleslami said: “Understanding how brain networking is disrupted in MND has been the focus of our research for the past 10 years. This work shows that we are on the right track, and that the technologies we have developed to capture electrical activity in the brain can identify important differences between different patient groups.” 11