MS Briefs

Persons with multiple sclerosis (MS) who have greater disability exhibit higher body fat and lower bone tissue content and density than those with mild disability, a recent study found. Researchers conducted a cross-sectional investigation of 47 ambulatory persons with relapsing remitting MS who were grouped by Expanded Disability Status Scale (EDSS) scores as having mild (1.0‒4.0; n=26) or moderate (4.5‒6.5; n=21) disability. Main outcome measures were whole-body and regional soft tissue composition (%body fat [BF], fat mass [FM], and fat-free soft tissue mass [FFM]), bone mineral content (BMC), and bone mineral density (BMD). Other outcomes included physical fitness, mobility, cognitive processing speed, symptoms, and health-related quality of life (HRQOL). They found:

• Whole-body and regional %BF and FM were significantly higher, and whole-body and appendicular BMC and BMD were significantly lower in participants with moderate disability than those with mild disability.
• There were no significant differences in whole-body or regional FFM by disability status.
• In the overall sample, body fat correlated significantly with cardiorespiratory fitness, pain symptoms, and psychological HRQOL.
• FFM and BMC correlated primarily with measures of muscular strength.

Pilutti LA, Motl RW. Body composition and disability in people with multiple sclerosis: A dual-energy x-ray absorptiometry study. [Published online ahead of print January 3, 2019]. Mult Scler Relat Disord. doi:10.1016/j.msard.2019.01.009.

Persons with multiple sclerosis (MS) who have greater disability exhibit higher body fat and lower bone tissue content and density than those with mild disability, a recent study found. Researchers conducted a cross-sectional investigation of 47 ambulatory persons with relapsing remitting MS who were grouped by Expanded Disability Status Scale (EDSS) scores as having mild (1.0‒4.0; n=26) or moderate (4.5‒6.5; n=21) disability. Main outcome measures were whole-body and regional soft tissue composition (%body fat [BF], fat mass [FM], and fat-free soft tissue mass [FFM]), bone mineral content (BMC), and bone mineral density (BMD). Other outcomes included physical fitness, mobility, cognitive processing speed, symptoms, and health-related quality of life (HRQOL). They found:

• Whole-body and regional %BF and FM were significantly higher, and whole-body and appendicular BMC and BMD were significantly lower in participants with moderate disability than those with mild disability.
• There were no significant differences in whole-body or regional FFM by disability status.
• In the overall sample, body fat correlated significantly with cardiorespiratory fitness, pain symptoms, and psychological HRQOL.
• FFM and BMC correlated primarily with measures of muscular strength.

Pilutti LA, Motl RW. Body composition and disability in people with multiple sclerosis: A dual-energy x-ray absorptiometry study. [Published online ahead of print January 3, 2019]. Mult Scler Relat Disord. doi:10.1016/j.msard.2019.01.009.

Persons with multiple sclerosis (MS) who have greater disability exhibit higher body fat and lower bone tissue content and density than those with mild disability, a recent study found. Researchers conducted a cross-sectional investigation of 47 ambulatory persons with relapsing remitting MS who were grouped by Expanded Disability Status Scale (EDSS) scores as having mild (1.0‒4.0; n=26) or moderate (4.5‒6.5; n=21) disability. Main outcome measures were whole-body and regional soft tissue composition (%body fat [BF], fat mass [FM], and fat-free soft tissue mass [FFM]), bone mineral content (BMC), and bone mineral density (BMD). Other outcomes included physical fitness, mobility, cognitive processing speed, symptoms, and health-related quality of life (HRQOL). They found:

• Whole-body and regional %BF and FM were significantly higher, and whole-body and appendicular BMC and BMD were significantly lower in participants with moderate disability than those with mild disability.
• There were no significant differences in whole-body or regional FFM by disability status.
• In the overall sample, body fat correlated significantly with cardiorespiratory fitness, pain symptoms, and psychological HRQOL.
• FFM and BMC correlated primarily with measures of muscular strength.

Pilutti LA, Motl RW. Body composition and disability in people with multiple sclerosis: A dual-energy x-ray absorptiometry study. [Published online ahead of print January 3, 2019]. Mult Scler Relat Disord. doi:10.1016/j.msard.2019.01.009.

The prevalence of pseudobulbar affect (PBA) in multiple sclerosis (MS) is low, according to a recent study, but similar symptoms may co-occur or overlap with depression, highlighting the importance of concomitant assessment of mood when evaluating potential PBA. Furthermore, PBA may be associated with cognitive impairment in people with MS. North American Research Committee on MS (NARCOMS) registry participants completed the Center for Neurologic Study-Lability Scale (CNS-LS), a validated 7-question self-report measure of PBA. Researchers categorized individuals as PBA-positive (PBA[+]) if they had a composite score ≥17 without current depression. Participants also reported their demographic characteristics and their clinical characteristics using Patient-Determined Disease Steps and Performance Scales. They found:

• Of the 8,136 responders, 574 (7%) had scores ≥17 on the CNS-LS; however, only 200 (2.5%) individuals had scores ≥17 without comorbid depression, of whom only 22 (11%) reported a diagnosis of PBA.
• PBA(+) individuals tended to be younger (mean [SD] 53.4 [11.0] vs 57.2 [10.3] years), non-white (13% vs 9%), and have lower socioeconomic status (≤$30,000 annual income: 28% vs 22%).
• In multivariable models, PBA(+) was associated with increased odds of more severe cognitive impairment.

Fitzgerald KC, Salter A, Tyry T, Fox RJ, Cutter G, Marrie RA. Pseudobulbar affect.

Prevalence and association with symptoms in multiple sclerosis. Neurol Clin Pract. 2018;8(6):472-481. doi:10.1212/CPJ.0000000000000523.

The prevalence of pseudobulbar affect (PBA) in multiple sclerosis (MS) is low, according to a recent study, but similar symptoms may co-occur or overlap with depression, highlighting the importance of concomitant assessment of mood when evaluating potential PBA. Furthermore, PBA may be associated with cognitive impairment in people with MS. North American Research Committee on MS (NARCOMS) registry participants completed the Center for Neurologic Study-Lability Scale (CNS-LS), a validated 7-question self-report measure of PBA. Researchers categorized individuals as PBA-positive (PBA[+]) if they had a composite score ≥17 without current depression. Participants also reported their demographic characteristics and their clinical characteristics using Patient-Determined Disease Steps and Performance Scales. They found:

• Of the 8,136 responders, 574 (7%) had scores ≥17 on the CNS-LS; however, only 200 (2.5%) individuals had scores ≥17 without comorbid depression, of whom only 22 (11%) reported a diagnosis of PBA.
• PBA(+) individuals tended to be younger (mean [SD] 53.4 [11.0] vs 57.2 [10.3] years), non-white (13% vs 9%), and have lower socioeconomic status (≤$30,000 annual income: 28% vs 22%).
• In multivariable models, PBA(+) was associated with increased odds of more severe cognitive impairment.

Fitzgerald KC, Salter A, Tyry T, Fox RJ, Cutter G, Marrie RA. Pseudobulbar affect.

Prevalence and association with symptoms in multiple sclerosis. Neurol Clin Pract. 2018;8(6):472-481. doi:10.1212/CPJ.0000000000000523.

The prevalence of pseudobulbar affect (PBA) in multiple sclerosis (MS) is low, according to a recent study, but similar symptoms may co-occur or overlap with depression, highlighting the importance of concomitant assessment of mood when evaluating potential PBA. Furthermore, PBA may be associated with cognitive impairment in people with MS. North American Research Committee on MS (NARCOMS) registry participants completed the Center for Neurologic Study-Lability Scale (CNS-LS), a validated 7-question self-report measure of PBA. Researchers categorized individuals as PBA-positive (PBA[+]) if they had a composite score ≥17 without current depression. Participants also reported their demographic characteristics and their clinical characteristics using Patient-Determined Disease Steps and Performance Scales. They found:

• Of the 8,136 responders, 574 (7%) had scores ≥17 on the CNS-LS; however, only 200 (2.5%) individuals had scores ≥17 without comorbid depression, of whom only 22 (11%) reported a diagnosis of PBA.
• PBA(+) individuals tended to be younger (mean [SD] 53.4 [11.0] vs 57.2 [10.3] years), non-white (13% vs 9%), and have lower socioeconomic status (≤$30,000 annual income: 28% vs 22%).
• In multivariable models, PBA(+) was associated with increased odds of more severe cognitive impairment.

Fitzgerald KC, Salter A, Tyry T, Fox RJ, Cutter G, Marrie RA. Pseudobulbar affect.

Prevalence and association with symptoms in multiple sclerosis. Neurol Clin Pract. 2018;8(6):472-481. doi:10.1212/CPJ.0000000000000523.