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MSWA Bulletin Magazine Winter 2021

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RESEARCH RESEARCH ROUND UP SUE SHAPLAND RN, BN, MSCN GENERAL MANAGER STRATEGIC SUPPORTS AND RESIDENTIAL OPTIONS FROM MULTIPLE SCLEROSIS NEWS TODAY Read more at: Sleep deprivation may worsen memory in early MS; James Sumowski et al; May 05, 2021. A new study suggests that sleep deprivation may worsen memory in people with clinically isolated syndrome (CIS) or relapsingremitting multiple sclerosis (RRMS). The study ‘Sleep disturbance and memory dysfunction in early multiple sclerosis’ was published in Annals of Clinical and Translational Neurology. 185 adults diagnosed with CIS or RRMS in the previous five years were included and underwent a number of assessments, including a patient-reported sleep disturbance questionnaire, and measures of memory and cognitive speed. The memory and cognition tasks were also completed by 50 healthy controls with matched characteristics to the MS patients in the study. Overall, 40.2% of PwMSs reported sleep disturbances. However, those with trouble sleeping reported worse mood and increased fatigue and had a higher number of brain lesions than those without sleep disturbances. Relative to healthy controls, memory was worse among patients with sleep disturbance, but not among patients without sleep disturbance. Based on studies, an explanation for the link between sleep and memory could be that inadequate rest impairs the hippocampus’ ability to process new information, leading to worse memory. The team concluded that their observations “connect patient-reported sleep disturbance specifically to poor memory in early MS.” Destroying myelin-damaging immune cells may be new therapy Recent research findings in Japan, using the mouse model, may potentially lead to a new therapy for MS. Vesicles containing the chemotherapeutic agent doxorubicin were used to destroy the aberrant, myelin-damaging immune cells that contribute to MS suppressing progression. The team tested this strategy in mice with experimental autoimmune encephalomyelitis (EAE). They discovered that their therapy, designated MOG-LipDOX, suppressed EAE symptoms through targeting T-cells, a class of immune cells primed to attack ‘foreign’ molecules that invade the body, such as viruses and bacteria. Specifically, the treatment successfully suppressed symptoms for more than 100 days and completely cured two mice — and without weight changes or signs of liver damage. The researchers found no evidence of immune cells infiltrating the central nervous system, ie, the brain and spinal cord, which is where the loss of myelin takes place. “The present study suggests that the use of these autoantigen-modified liposomes promises to be a suitable therapeutic approach for the cure of MS,” they concluded. 12

HERE WE PROVIDE SOME SUMMARIES OF RESEARCH SOURCED FROM WEBSITES IN AUSTRALIA AND AROUND THE WORLD; WE HOPE IT’S OF INTEREST TO YOU. READ MORE AT MSWA.ORG.AU/RESEARCHUPDATE FROM THE INTERNATIONAL PROGRESSIVE MS ALLIANCE Read more at: FDA backs further development of blood biomarker, neurofilament light, for clinical trials in MS A major milestone in the goal of increasing the number and speed of clinical trials in progressive MS was recently achieved when The International Progressive MS Alliance recently received a letter of support from the U.S. Food and Drug Administration (FDA). The letter encourages the exploration and development of further studies around a molecule in blood serum or plasma — neurofilament light chain (NfL) — as a potential rapid indicator of the value of an experimental therapy in early trials involving people with progressive MS. NfL is a fragment in the debris that enters the spinal fluid and blood when nerve wires (axons) are damaged. Studies of NfL have been underway to define how this biomarker may be used to help detect and predict disease activity and response to treatments, not only in MS but in other disorders. NfL may reflect ongoing disease pathology and may be more responsive to the effects of treatments than traditional imaging (MRI) outcomes in early phase trials. Dr. Robert J. Fox, Vice Chair of the Alliance’s Scientific Steering Committee said, “Having a simple blood test to quickly track the potential benefits of experimental therapies would be an enormous step forward for people with progressive MS, for whom there are too few therapies.” FROM MENZIES HEALTH INSTITUTE QUEENSLAND Read more at: Etanercept (Enbrel) trial in stroke Stroke is Australia's second largest cause of death, with one person suffering from the disease every 10 minutes. An experimental treatment in the US is giving some stroke patients immediate relief and Griffith University (Queensland) has a clinical trial to examine its potential. The US FDA has approved Etanercept (Enbrel) for many years as a therapy to treat inflammatory diseases such as rheumatoid arthritis. Recently, doctors have begun using it to treat strokes. Studies in the US demonstrated peri spinal Enbrel improved mobility and pain in chronic stroke participants, concluding: Enbrel can provide significant and ongoing benefits for the chronic post-stroke management of pain and greater shoulder flexion by the paretic arm. Effects are rapid and highly significant, supporting direct action on brain function. A second Griffith University Stroke Trial is now successfully underway enrolling 80 participants. They have seen some spectacular responses in several of our participants. The focus of the trial is those who have had a stroke but experienced major fatigue since and also have some functioning and capacity to raise their stroke affected arm. FROM PRILENIA THERAPEUTICS Read more at: Phase 3 Huntington’s disease clinical trial news Pridopidine is being assessed in ongoing phase 3 global clinical trial PROOF-HD (PRidopidine Outcome On Function in Huntington’s Disease). The PROOF-HD phase 3 study is being conducted in approximately 60 sites in collaboration with the Huntington Study Group (HSG) in North America and Europe, enrolling people with early Huntington’s. If successful in the trial this may lead to its approval as a treatment for Huntington’s disease. In prior clinical trials in HD patients, pridopidine demonstrated a beneficial effect in maintaining functional capacity after one year. HD patients and families highlight decreased functional capacity as a major burden on daily life. The Total Functional Capacity (TFC) scale is widely used by clinicians to assess disease stage and progression. This captures changes in HD patients' capacity to continue working, perform household activities, eat, dress, walk, and complete simple tasks. Pridopidine is the first drug to show maintenance of TFC at one year. This effect may also be seen and maintained for five years, as demonstrated in an open-label trial. The purpose of the study is to evaluate the effect of pridopidine on functional capacity, as well as on motor and behavioural features over 65 weeks. 13

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