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Concussion in adolescents tied to MS risk

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Key clinical point: Concussions in adolescents correlate to an elevated risk for multiple sclerosis (MS).

Major finding: The risk for MS was higher among patients exposed to a concussion in adolescence (hazard ratio [HR], 1.29; P = .03). Sex-specific analysis revealed a higher risk for MS only in males who sustained a concussion in adolescence (HR, 1.41; P = 0.04).

Study details: Retrospective study included 97,965 patients (age, 11-18 years) exposed to a concussion who were matched to 293,895 unexposed patients; primary outcome was MS diagnosis.

Disclosures: This study was funded by an unrestricted investigator-initiated trial grant from Roche Canada and supported by ICES. The corresponding author has served on advisory boards for Biogen Idec, EMD Serono, Genzyme Canada, Novartis, and Roche; has received Investigator Initiated Grant Funds from Biogen Idec, Novartis, and Roche; and has acted as site PI for multicenter trials funded by Novartis, Genzyme, Roche, and AbbVie. All other authors declared no conflicts of interest.

Citation: Povolo CA et al. Mult Scler. 2020 Feb 24. doi: 10.1177/1352458520908037

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Key clinical point: Concussions in adolescents correlate to an elevated risk for multiple sclerosis (MS).

Major finding: The risk for MS was higher among patients exposed to a concussion in adolescence (hazard ratio [HR], 1.29; P = .03). Sex-specific analysis revealed a higher risk for MS only in males who sustained a concussion in adolescence (HR, 1.41; P = 0.04).

Study details: Retrospective study included 97,965 patients (age, 11-18 years) exposed to a concussion who were matched to 293,895 unexposed patients; primary outcome was MS diagnosis.

Disclosures: This study was funded by an unrestricted investigator-initiated trial grant from Roche Canada and supported by ICES. The corresponding author has served on advisory boards for Biogen Idec, EMD Serono, Genzyme Canada, Novartis, and Roche; has received Investigator Initiated Grant Funds from Biogen Idec, Novartis, and Roche; and has acted as site PI for multicenter trials funded by Novartis, Genzyme, Roche, and AbbVie. All other authors declared no conflicts of interest.

Citation: Povolo CA et al. Mult Scler. 2020 Feb 24. doi: 10.1177/1352458520908037

Key clinical point: Concussions in adolescents correlate to an elevated risk for multiple sclerosis (MS).

Major finding: The risk for MS was higher among patients exposed to a concussion in adolescence (hazard ratio [HR], 1.29; P = .03). Sex-specific analysis revealed a higher risk for MS only in males who sustained a concussion in adolescence (HR, 1.41; P = 0.04).

Study details: Retrospective study included 97,965 patients (age, 11-18 years) exposed to a concussion who were matched to 293,895 unexposed patients; primary outcome was MS diagnosis.

Disclosures: This study was funded by an unrestricted investigator-initiated trial grant from Roche Canada and supported by ICES. The corresponding author has served on advisory boards for Biogen Idec, EMD Serono, Genzyme Canada, Novartis, and Roche; has received Investigator Initiated Grant Funds from Biogen Idec, Novartis, and Roche; and has acted as site PI for multicenter trials funded by Novartis, Genzyme, Roche, and AbbVie. All other authors declared no conflicts of interest.

Citation: Povolo CA et al. Mult Scler. 2020 Feb 24. doi: 10.1177/1352458520908037

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Vitamin D levels tied to clinical and radiological outcomes in early relapsing MS

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Key clinical point: Serum 25(OH)D levels are associated with a modest decrease in relapse rate and radiological inflammatory activities in patients with early relapsing multiple sclerosis (MS).

Major finding: Each 25 nmol/L increase in serum 25(OH)D levels is associated with a decrease in clinical relapse rate (risk ratio [RR], 0.90), gadolinium-enhancing lesions (RR, 0.69), new/enlarging T2 lesions (RR, 0.86), and new active lesions (RR, 0.81) in the magnetic resonance imaging. 

Study details: Meta-analysis of 13 studies including 3,498 patients.

Disclosures: No study sponsor was identified.

Citation: Martínez-Lapiscina EH et al. J Neurol Sci. 2020 Jan 25. doi: 10.1016/j.jns.2020.116668.

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Key clinical point: Serum 25(OH)D levels are associated with a modest decrease in relapse rate and radiological inflammatory activities in patients with early relapsing multiple sclerosis (MS).

Major finding: Each 25 nmol/L increase in serum 25(OH)D levels is associated with a decrease in clinical relapse rate (risk ratio [RR], 0.90), gadolinium-enhancing lesions (RR, 0.69), new/enlarging T2 lesions (RR, 0.86), and new active lesions (RR, 0.81) in the magnetic resonance imaging. 

Study details: Meta-analysis of 13 studies including 3,498 patients.

Disclosures: No study sponsor was identified.

Citation: Martínez-Lapiscina EH et al. J Neurol Sci. 2020 Jan 25. doi: 10.1016/j.jns.2020.116668.

Key clinical point: Serum 25(OH)D levels are associated with a modest decrease in relapse rate and radiological inflammatory activities in patients with early relapsing multiple sclerosis (MS).

Major finding: Each 25 nmol/L increase in serum 25(OH)D levels is associated with a decrease in clinical relapse rate (risk ratio [RR], 0.90), gadolinium-enhancing lesions (RR, 0.69), new/enlarging T2 lesions (RR, 0.86), and new active lesions (RR, 0.81) in the magnetic resonance imaging. 

Study details: Meta-analysis of 13 studies including 3,498 patients.

Disclosures: No study sponsor was identified.

Citation: Martínez-Lapiscina EH et al. J Neurol Sci. 2020 Jan 25. doi: 10.1016/j.jns.2020.116668.

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Cannabis use among patients with MS and spasticity

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Key clinical point: A significant proportion of patients with multiple sclerosis (MS) and spasticity from Oregon, US reported cannabis use and found it beneficial for their pain and spasticity.

Major finding: Among the patients assessed, 54% reported using cannabis in the past and 36% reported current use of cannabis. For the treatment of spasticity, 26% of patients used both prescribed medications and cannabis. Among current users, 85% and 79% of patients reported cannabis being somewhat to very helpful for pain and spasticity, respectively.

Study details: A cross-sectional study evaluated the cannabis use and its perceived benefits among patients with MS and self-reported spasticity (n = 91) who were enrolled in a randomized controlled trial for MS-related spasticity in Oregon, US.

Disclosures: The study was supported by the VA Office of Research and Development via Rehabilitation Research and Development. Dr. Rice reported consulting for Greenwich Biosciences. Dr. Cameron reported consulting for Adamas Pharmaceuticals Inc. and Greenwich Biosciences. Ms. Hugos and Ms. Hildebrand declared no conflict of interest.

Citation: Rice J et al. Mult Scler Relat Disord. 2020 Feb 11. doi: 10.1016/j.msard.2020.102009.

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Key clinical point: A significant proportion of patients with multiple sclerosis (MS) and spasticity from Oregon, US reported cannabis use and found it beneficial for their pain and spasticity.

Major finding: Among the patients assessed, 54% reported using cannabis in the past and 36% reported current use of cannabis. For the treatment of spasticity, 26% of patients used both prescribed medications and cannabis. Among current users, 85% and 79% of patients reported cannabis being somewhat to very helpful for pain and spasticity, respectively.

Study details: A cross-sectional study evaluated the cannabis use and its perceived benefits among patients with MS and self-reported spasticity (n = 91) who were enrolled in a randomized controlled trial for MS-related spasticity in Oregon, US.

Disclosures: The study was supported by the VA Office of Research and Development via Rehabilitation Research and Development. Dr. Rice reported consulting for Greenwich Biosciences. Dr. Cameron reported consulting for Adamas Pharmaceuticals Inc. and Greenwich Biosciences. Ms. Hugos and Ms. Hildebrand declared no conflict of interest.

Citation: Rice J et al. Mult Scler Relat Disord. 2020 Feb 11. doi: 10.1016/j.msard.2020.102009.

Key clinical point: A significant proportion of patients with multiple sclerosis (MS) and spasticity from Oregon, US reported cannabis use and found it beneficial for their pain and spasticity.

Major finding: Among the patients assessed, 54% reported using cannabis in the past and 36% reported current use of cannabis. For the treatment of spasticity, 26% of patients used both prescribed medications and cannabis. Among current users, 85% and 79% of patients reported cannabis being somewhat to very helpful for pain and spasticity, respectively.

Study details: A cross-sectional study evaluated the cannabis use and its perceived benefits among patients with MS and self-reported spasticity (n = 91) who were enrolled in a randomized controlled trial for MS-related spasticity in Oregon, US.

Disclosures: The study was supported by the VA Office of Research and Development via Rehabilitation Research and Development. Dr. Rice reported consulting for Greenwich Biosciences. Dr. Cameron reported consulting for Adamas Pharmaceuticals Inc. and Greenwich Biosciences. Ms. Hugos and Ms. Hildebrand declared no conflict of interest.

Citation: Rice J et al. Mult Scler Relat Disord. 2020 Feb 11. doi: 10.1016/j.msard.2020.102009.

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Multidisciplinary rehabilitation can improve highly impacting symptoms of relapse-onset MS

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Key clinical point: The personalized multidisciplinary rehabilitation (PMDR) approach can improve highly impacting symptoms in patients with relapse-onset multiple sclerosis (MS) and have a positive influence on their quality of life.

Major finding: Patients receiving PMDR had a reduction in perceived fatigue and improvement of walking abilities and health-related quality of life compared with control individuals. Improved performance on a motor sequence learning task in terms of accuracy was observed after rehabilitation. All improvements persisted at the 4-week follow-up. 

Study details: A longitudinal parallel group study included 24 patients with relapse-onset MS, who received a 4-week PMDR, and 24 control individuals. 

Disclosures: The study was supported by the Swiss Multiple Sclerosis Society. Athina Papadopoulou, Laura Gaetano, Katrin Parmar, Thierry Ettlin, Corina Schuster-Amft, Jens Wuerfel, Ludwig Kappos, Till Sprenger, and Stefano Magon reported receiving research support/speaker fees/speaker honoraria/travel support/consultancy fees/advisory fees from one or more pharmaceutical companies and/or organizations. The remaining authors declared no conflict of interest.

Citation: Zuber P et al. J Neurol. 2020 Mar 2. doi: 10.1007/s00415-020-09768-6.

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Key clinical point: The personalized multidisciplinary rehabilitation (PMDR) approach can improve highly impacting symptoms in patients with relapse-onset multiple sclerosis (MS) and have a positive influence on their quality of life.

Major finding: Patients receiving PMDR had a reduction in perceived fatigue and improvement of walking abilities and health-related quality of life compared with control individuals. Improved performance on a motor sequence learning task in terms of accuracy was observed after rehabilitation. All improvements persisted at the 4-week follow-up. 

Study details: A longitudinal parallel group study included 24 patients with relapse-onset MS, who received a 4-week PMDR, and 24 control individuals. 

Disclosures: The study was supported by the Swiss Multiple Sclerosis Society. Athina Papadopoulou, Laura Gaetano, Katrin Parmar, Thierry Ettlin, Corina Schuster-Amft, Jens Wuerfel, Ludwig Kappos, Till Sprenger, and Stefano Magon reported receiving research support/speaker fees/speaker honoraria/travel support/consultancy fees/advisory fees from one or more pharmaceutical companies and/or organizations. The remaining authors declared no conflict of interest.

Citation: Zuber P et al. J Neurol. 2020 Mar 2. doi: 10.1007/s00415-020-09768-6.

Key clinical point: The personalized multidisciplinary rehabilitation (PMDR) approach can improve highly impacting symptoms in patients with relapse-onset multiple sclerosis (MS) and have a positive influence on their quality of life.

Major finding: Patients receiving PMDR had a reduction in perceived fatigue and improvement of walking abilities and health-related quality of life compared with control individuals. Improved performance on a motor sequence learning task in terms of accuracy was observed after rehabilitation. All improvements persisted at the 4-week follow-up. 

Study details: A longitudinal parallel group study included 24 patients with relapse-onset MS, who received a 4-week PMDR, and 24 control individuals. 

Disclosures: The study was supported by the Swiss Multiple Sclerosis Society. Athina Papadopoulou, Laura Gaetano, Katrin Parmar, Thierry Ettlin, Corina Schuster-Amft, Jens Wuerfel, Ludwig Kappos, Till Sprenger, and Stefano Magon reported receiving research support/speaker fees/speaker honoraria/travel support/consultancy fees/advisory fees from one or more pharmaceutical companies and/or organizations. The remaining authors declared no conflict of interest.

Citation: Zuber P et al. J Neurol. 2020 Mar 2. doi: 10.1007/s00415-020-09768-6.

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60% of morbidity comes from 30% of patients with moderate-to-severe MS

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Key clinical point: Patients with moderate-to-severe multiple sclerosis (MS) contribute substantially to the disease-related morbidity burden.

Major finding: Patients in asymptomatic and mild stages of MS represent 68.4% of the population and contribute to 39.8% of the MS-specific morbidity. The remaining 60.2% of the MS-specific morbidity comes from the 31.6% of patients in the moderate or severe disease stages. 

Study details: The data come from an analysis of 1,412 patients with MS identified from the Swiss Multiple Sclerosis Registry. 

Disclosures: The study was supported by the Swiss Multiple Sclerosis Society. Anke Salmen, Claudio Gobbi, Caroline Pot, Christian P. Kamm, Jens Kuhle, Pasquale Calabrese, Stefanie Müller, and Sven Schippling reported research support/speaker fees/speaker honoraria/travel support/consultancy fees/advisory fees from one or more pharmaceutical companies and/or organizations. The remaining authors declared no conflict of interest.

Citation: Kaufmann M et al. Front Neurol. 2020 Mar 6. doi: 10.3389/fneur.2020.00156.

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Key clinical point: Patients with moderate-to-severe multiple sclerosis (MS) contribute substantially to the disease-related morbidity burden.

Major finding: Patients in asymptomatic and mild stages of MS represent 68.4% of the population and contribute to 39.8% of the MS-specific morbidity. The remaining 60.2% of the MS-specific morbidity comes from the 31.6% of patients in the moderate or severe disease stages. 

Study details: The data come from an analysis of 1,412 patients with MS identified from the Swiss Multiple Sclerosis Registry. 

Disclosures: The study was supported by the Swiss Multiple Sclerosis Society. Anke Salmen, Claudio Gobbi, Caroline Pot, Christian P. Kamm, Jens Kuhle, Pasquale Calabrese, Stefanie Müller, and Sven Schippling reported research support/speaker fees/speaker honoraria/travel support/consultancy fees/advisory fees from one or more pharmaceutical companies and/or organizations. The remaining authors declared no conflict of interest.

Citation: Kaufmann M et al. Front Neurol. 2020 Mar 6. doi: 10.3389/fneur.2020.00156.

Key clinical point: Patients with moderate-to-severe multiple sclerosis (MS) contribute substantially to the disease-related morbidity burden.

Major finding: Patients in asymptomatic and mild stages of MS represent 68.4% of the population and contribute to 39.8% of the MS-specific morbidity. The remaining 60.2% of the MS-specific morbidity comes from the 31.6% of patients in the moderate or severe disease stages. 

Study details: The data come from an analysis of 1,412 patients with MS identified from the Swiss Multiple Sclerosis Registry. 

Disclosures: The study was supported by the Swiss Multiple Sclerosis Society. Anke Salmen, Claudio Gobbi, Caroline Pot, Christian P. Kamm, Jens Kuhle, Pasquale Calabrese, Stefanie Müller, and Sven Schippling reported research support/speaker fees/speaker honoraria/travel support/consultancy fees/advisory fees from one or more pharmaceutical companies and/or organizations. The remaining authors declared no conflict of interest.

Citation: Kaufmann M et al. Front Neurol. 2020 Mar 6. doi: 10.3389/fneur.2020.00156.

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Elevated D-dimer after infusion of alemtuzumab in patients with MS

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Key clinical point: Alemtuzumab infusion in patients with multiple sclerosis (MS) is associated with the elevation of D-dimer level and the prolongation of prothrombin time (PT).

Major finding: Alemtuzumab infusion resulted in a significant elevation in D-dimer levels within the patient group (before vs after infusion, P = .00001) and also compared with control individuals (P = .00001). PT was also prolonged in patients receiving alemtuzumab post-infusion compared with the pre-infusion values (P = .00001).

Study details: In this study, coagulation parameters were analyzed in 13 patients with MS treated with alemtuzumab and 13 control individuals.

Disclosures: The study was supported by the MH CZ-DRO, Motol University Hospital, Prague, Czech Republic. Jana Libertinova, Eva Meluzinova, Eva Nema, Petra Rockova, Martin Elisak, Marko Petrzalka, and Hana Mojzisova reported receiving compensation for travel and/or speaker honoraria and consultant fees from multiple pharmaceutical companies. The remaining authors declared no conflict of interest. 

Citation: Libertinova J et al. Mult Scler. 2020 Feb 20. doi: 10.1177/1352458520904277

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Key clinical point: Alemtuzumab infusion in patients with multiple sclerosis (MS) is associated with the elevation of D-dimer level and the prolongation of prothrombin time (PT).

Major finding: Alemtuzumab infusion resulted in a significant elevation in D-dimer levels within the patient group (before vs after infusion, P = .00001) and also compared with control individuals (P = .00001). PT was also prolonged in patients receiving alemtuzumab post-infusion compared with the pre-infusion values (P = .00001).

Study details: In this study, coagulation parameters were analyzed in 13 patients with MS treated with alemtuzumab and 13 control individuals.

Disclosures: The study was supported by the MH CZ-DRO, Motol University Hospital, Prague, Czech Republic. Jana Libertinova, Eva Meluzinova, Eva Nema, Petra Rockova, Martin Elisak, Marko Petrzalka, and Hana Mojzisova reported receiving compensation for travel and/or speaker honoraria and consultant fees from multiple pharmaceutical companies. The remaining authors declared no conflict of interest. 

Citation: Libertinova J et al. Mult Scler. 2020 Feb 20. doi: 10.1177/1352458520904277

Key clinical point: Alemtuzumab infusion in patients with multiple sclerosis (MS) is associated with the elevation of D-dimer level and the prolongation of prothrombin time (PT).

Major finding: Alemtuzumab infusion resulted in a significant elevation in D-dimer levels within the patient group (before vs after infusion, P = .00001) and also compared with control individuals (P = .00001). PT was also prolonged in patients receiving alemtuzumab post-infusion compared with the pre-infusion values (P = .00001).

Study details: In this study, coagulation parameters were analyzed in 13 patients with MS treated with alemtuzumab and 13 control individuals.

Disclosures: The study was supported by the MH CZ-DRO, Motol University Hospital, Prague, Czech Republic. Jana Libertinova, Eva Meluzinova, Eva Nema, Petra Rockova, Martin Elisak, Marko Petrzalka, and Hana Mojzisova reported receiving compensation for travel and/or speaker honoraria and consultant fees from multiple pharmaceutical companies. The remaining authors declared no conflict of interest. 

Citation: Libertinova J et al. Mult Scler. 2020 Feb 20. doi: 10.1177/1352458520904277

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Sexual dysfunction is highly prevalent in women with MS

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Key clinical point: Sexual dysfunction is highly prevalent in women with multiple sclerosis (MS), and it significantly affects their quality of life.

Major finding: The overall prevalence of sexual dysfunction in women with MS was 70.3%. Sexual dysfunction in women with MS had a significant correlation with age (P = .004), duration of marriage, (P = .004), fatigue (P less than or equal to .001), Expanded Disability Status Scale (P = .004), and the combined physical and mental health aspects of quality of life (P less than .05).                   

Study details: The data come from a cross-sectional study that was conducted in Iran, which included 300 married women with MS aged 22-50 years. 

Disclosures: The study was funded by the Isfahan University of Medical Sciences, Isfahan, Iran. The authors declared no conflict of interest.

Citation: Nazari F et al. BMC Urol. 2020 Feb 21. doi: 10.1186/s12894-020-0581-2.

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Key clinical point: Sexual dysfunction is highly prevalent in women with multiple sclerosis (MS), and it significantly affects their quality of life.

Major finding: The overall prevalence of sexual dysfunction in women with MS was 70.3%. Sexual dysfunction in women with MS had a significant correlation with age (P = .004), duration of marriage, (P = .004), fatigue (P less than or equal to .001), Expanded Disability Status Scale (P = .004), and the combined physical and mental health aspects of quality of life (P less than .05).                   

Study details: The data come from a cross-sectional study that was conducted in Iran, which included 300 married women with MS aged 22-50 years. 

Disclosures: The study was funded by the Isfahan University of Medical Sciences, Isfahan, Iran. The authors declared no conflict of interest.

Citation: Nazari F et al. BMC Urol. 2020 Feb 21. doi: 10.1186/s12894-020-0581-2.

Key clinical point: Sexual dysfunction is highly prevalent in women with multiple sclerosis (MS), and it significantly affects their quality of life.

Major finding: The overall prevalence of sexual dysfunction in women with MS was 70.3%. Sexual dysfunction in women with MS had a significant correlation with age (P = .004), duration of marriage, (P = .004), fatigue (P less than or equal to .001), Expanded Disability Status Scale (P = .004), and the combined physical and mental health aspects of quality of life (P less than .05).                   

Study details: The data come from a cross-sectional study that was conducted in Iran, which included 300 married women with MS aged 22-50 years. 

Disclosures: The study was funded by the Isfahan University of Medical Sciences, Isfahan, Iran. The authors declared no conflict of interest.

Citation: Nazari F et al. BMC Urol. 2020 Feb 21. doi: 10.1186/s12894-020-0581-2.

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Amyloid PET Findings Correlate With Cognitive Decline in MS

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Key clinical point: Lower amyloid positron imaging tomography (PET) uptake in normal-appearing white matter (NAWM) is associated with cognitive decline and an increase in white matter lesion volume.

Major finding: Cognitive decline was associated with lower standardized uptake value relative to cerebellum in NAWM (1.52 in the cognitive decline group vs. 1.67 in the cognitively stable group; Mann-Whitney U test [U] = 42.0; P = .011), lower thalamic volume (13.84 vs. 15.61; U = 55.0; P = .059), and higher white matter lesion burden (15.25 vs. 9.17; U = 49.0; P = .029).

Study details: A prospective longitudinal PET study using 18F-florbetaben included 29 patients diagnosed with MS; the mean follow-up period was 18.00 ± 3.31 months.

Disclosures: The authors declared no conflicts of interest.

Citation: Pytel V et al. Mult Scler Relat Disord. 2020 Jan 2. doi: 10.1016/j.msard.2020.101926

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Key clinical point: Lower amyloid positron imaging tomography (PET) uptake in normal-appearing white matter (NAWM) is associated with cognitive decline and an increase in white matter lesion volume.

Major finding: Cognitive decline was associated with lower standardized uptake value relative to cerebellum in NAWM (1.52 in the cognitive decline group vs. 1.67 in the cognitively stable group; Mann-Whitney U test [U] = 42.0; P = .011), lower thalamic volume (13.84 vs. 15.61; U = 55.0; P = .059), and higher white matter lesion burden (15.25 vs. 9.17; U = 49.0; P = .029).

Study details: A prospective longitudinal PET study using 18F-florbetaben included 29 patients diagnosed with MS; the mean follow-up period was 18.00 ± 3.31 months.

Disclosures: The authors declared no conflicts of interest.

Citation: Pytel V et al. Mult Scler Relat Disord. 2020 Jan 2. doi: 10.1016/j.msard.2020.101926

Key clinical point: Lower amyloid positron imaging tomography (PET) uptake in normal-appearing white matter (NAWM) is associated with cognitive decline and an increase in white matter lesion volume.

Major finding: Cognitive decline was associated with lower standardized uptake value relative to cerebellum in NAWM (1.52 in the cognitive decline group vs. 1.67 in the cognitively stable group; Mann-Whitney U test [U] = 42.0; P = .011), lower thalamic volume (13.84 vs. 15.61; U = 55.0; P = .059), and higher white matter lesion burden (15.25 vs. 9.17; U = 49.0; P = .029).

Study details: A prospective longitudinal PET study using 18F-florbetaben included 29 patients diagnosed with MS; the mean follow-up period was 18.00 ± 3.31 months.

Disclosures: The authors declared no conflicts of interest.

Citation: Pytel V et al. Mult Scler Relat Disord. 2020 Jan 2. doi: 10.1016/j.msard.2020.101926

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Mothers of Children With MS More Likely to Use Mental Health Services

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Key clinical point: Mothers of children with MS are more likely to use mental health services before and after their child’s diagnosis with multiple sclerosis (MS) than mothers of children without MS.

Major finding: The prevalence of any physical condition and mood or anxiety disorder was higher in MS-mothers vs. non-MS-mothers. The odds of having any psychiatry visit was significantly increased in MS-mothers (odds ratio, 1.60; 95% confidence interval [CI], 1.10-2.31). The annual rate of psychiatry visits did not differ between MS-mothers and non-MS-mothers (rate ratio, 0.66; 95% CI, 0.33-1.30).

Study details: A population-based retrospective matched cohort study of 156 MS-mothers and 624 non-MS mothers.

Disclosures: This study was funded by the Multiple Sclerosis Scientific Research Foundation. Dr. Marrie received research funding from CIHR, Research Manitoba, Multiple Sclerosis Society of Canada, Multiple Sclerosis Scientific Foundation, Crohn’s and Colitis Canada, National Multiple Sclerosis Society, and CMSC and was supported by the Waugh Family Chair in Multiple Sclerosis.

Citation: Marrie RA et al. Neurology. 2020 Jan 9. doi: 10.1212/WNL.0000000000008871. 

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Key clinical point: Mothers of children with MS are more likely to use mental health services before and after their child’s diagnosis with multiple sclerosis (MS) than mothers of children without MS.

Major finding: The prevalence of any physical condition and mood or anxiety disorder was higher in MS-mothers vs. non-MS-mothers. The odds of having any psychiatry visit was significantly increased in MS-mothers (odds ratio, 1.60; 95% confidence interval [CI], 1.10-2.31). The annual rate of psychiatry visits did not differ between MS-mothers and non-MS-mothers (rate ratio, 0.66; 95% CI, 0.33-1.30).

Study details: A population-based retrospective matched cohort study of 156 MS-mothers and 624 non-MS mothers.

Disclosures: This study was funded by the Multiple Sclerosis Scientific Research Foundation. Dr. Marrie received research funding from CIHR, Research Manitoba, Multiple Sclerosis Society of Canada, Multiple Sclerosis Scientific Foundation, Crohn’s and Colitis Canada, National Multiple Sclerosis Society, and CMSC and was supported by the Waugh Family Chair in Multiple Sclerosis.

Citation: Marrie RA et al. Neurology. 2020 Jan 9. doi: 10.1212/WNL.0000000000008871. 

Key clinical point: Mothers of children with MS are more likely to use mental health services before and after their child’s diagnosis with multiple sclerosis (MS) than mothers of children without MS.

Major finding: The prevalence of any physical condition and mood or anxiety disorder was higher in MS-mothers vs. non-MS-mothers. The odds of having any psychiatry visit was significantly increased in MS-mothers (odds ratio, 1.60; 95% confidence interval [CI], 1.10-2.31). The annual rate of psychiatry visits did not differ between MS-mothers and non-MS-mothers (rate ratio, 0.66; 95% CI, 0.33-1.30).

Study details: A population-based retrospective matched cohort study of 156 MS-mothers and 624 non-MS mothers.

Disclosures: This study was funded by the Multiple Sclerosis Scientific Research Foundation. Dr. Marrie received research funding from CIHR, Research Manitoba, Multiple Sclerosis Society of Canada, Multiple Sclerosis Scientific Foundation, Crohn’s and Colitis Canada, National Multiple Sclerosis Society, and CMSC and was supported by the Waugh Family Chair in Multiple Sclerosis.

Citation: Marrie RA et al. Neurology. 2020 Jan 9. doi: 10.1212/WNL.0000000000008871. 

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Low Vitamin D and BMI Are Causal Factors for MS

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Key clinical point: Vitamin D and body mass index (BMI) are independent causal risk factors for multiple sclerosis (MS) in adulthood and childhood.

Major finding: Genetically determined increased childhood BMI and adult BMI were associated with a 24% and 14% higher risk of MS, respectively. Each genetically determined unit increase in the natural-log-transformed vitamin D level was associated with a 43% reduction in the MS risk. 

Study details: A 2-sample Mendelian randomization study estimated the effect of BMI and vitamin D status on MS risk; associations of single-nucleotide polymorphisms with both the risk factors of interest were obtained from the relevant consortia.

Disclosures: This study was funded through a grant from the Barts Charity. The authors declared no conflicts of interest.

Citation: Jacobs BM et al. Neurol Neuroimmunol Neuroinflamm. 2020 Jan 14. doi: 10.1212/NXI.0000000000000662

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Key clinical point: Vitamin D and body mass index (BMI) are independent causal risk factors for multiple sclerosis (MS) in adulthood and childhood.

Major finding: Genetically determined increased childhood BMI and adult BMI were associated with a 24% and 14% higher risk of MS, respectively. Each genetically determined unit increase in the natural-log-transformed vitamin D level was associated with a 43% reduction in the MS risk. 

Study details: A 2-sample Mendelian randomization study estimated the effect of BMI and vitamin D status on MS risk; associations of single-nucleotide polymorphisms with both the risk factors of interest were obtained from the relevant consortia.

Disclosures: This study was funded through a grant from the Barts Charity. The authors declared no conflicts of interest.

Citation: Jacobs BM et al. Neurol Neuroimmunol Neuroinflamm. 2020 Jan 14. doi: 10.1212/NXI.0000000000000662

Key clinical point: Vitamin D and body mass index (BMI) are independent causal risk factors for multiple sclerosis (MS) in adulthood and childhood.

Major finding: Genetically determined increased childhood BMI and adult BMI were associated with a 24% and 14% higher risk of MS, respectively. Each genetically determined unit increase in the natural-log-transformed vitamin D level was associated with a 43% reduction in the MS risk. 

Study details: A 2-sample Mendelian randomization study estimated the effect of BMI and vitamin D status on MS risk; associations of single-nucleotide polymorphisms with both the risk factors of interest were obtained from the relevant consortia.

Disclosures: This study was funded through a grant from the Barts Charity. The authors declared no conflicts of interest.

Citation: Jacobs BM et al. Neurol Neuroimmunol Neuroinflamm. 2020 Jan 14. doi: 10.1212/NXI.0000000000000662

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