Articles related to MULTIPLE SCLEROSIS (MS)

Shift work has previously been linked to an increased risk of developing MS, presumably due to the resulting sleep deprivation and circadian desynchrony. The current study compared sleeping 7–9 hours/night during adolescence, with less than 7 hours/night and found a 40% increase in risk for developing MS in the short-sleep cohort. The authors conclude that “insufficient sleep and low sleep quality during adolescence seem to increase the risk of subsequently developing MS.”

This 10-year study is the first large, population-based assessment of spasticity treatment in MS. It reveals that younger, newly diagnosed people are prescribed baclofen more their older peers. This is the first study to show high rates of baclofen discontinuation among all patients with MS, with more than 50% of patients discontinued treatment within 6 months.

In addition to stroke, central causes of vertigo include brainstem glioma, medulloblastoma, vestibular schwannoma, and vestibular migraine. Peripheral causes include BPPV, Meniere disease, acute labyrinthitis, vestibular neuritis, and multiple sclerosis.

Relapsing MS treatment remains difficult, and new therapeutic targets have been investigated. S1P, a bioactive lysophospholipid signaling molecule present in several organs, including the central nervous system, is one such target. S1P plays a role in a variety of physiologic and pathophysiologic processes. S1P levels have been linked to disease progression in the brain parenchyma and cerebrospinal fluid of MS patients. There are 5 recognized S1PR subtypes, and depending on the receptor being targeted, their expression patterns and outcomes change. S1PRMs are a more recent class of RMS treatments, and the FDA has currently approved 4 of these treatments: fingolimod, siponimod, ozanimod, and ponesimod.

Panelists conclude that sNfL can be used as a biomarker to assess response totreatment in future trials. In the clinic setting, it could become valuable in directingtherapy; for example, in cases in which the patient is absent clinical signs of aggressiveMS and it’s unclear if they will benefit from infused, injected, or oral disease-modifyingtherapy.

In this Journal Club discussion, among participants in the vaccine-CD20-vaccine cohort, 100% of participants experienced a measurable response to a third dose of a COVID-19 vaccine compared with 18% in the CD20-vaccine cohort.