Multiple Sclerosis

Young Smokers Increase Risk for Multiple Sclerosis

ababb@aan.com — Fri, 20 Feb 2009 22:00:00 GMT

People who start smoking before age 17 may increase their risk for developing multiple sclerosis (MS), according to a study released today that will be presented at the American Academy of Neurology's 61st Annual Meeting in Seattle, April 25 to May 2, 2009. The study involved 87 people with MS who were among more than 30,000 people in a larger study. The people with MS were divided into three groups: non-smokers, early smokers (smokers who began before age 17), and late smokers (those who started smoking at 17 or older), and matched by age, gender, and race to 435 people without MS. Early smokers were 2.7 times more likely to develop MS than nonsmokers. Late smokers did not have an increased risk for the disease. More than 32 percent of the MS patients were early smokers, compared to 19 percent of the people without MS. "Studies show that environmental factors play a prominent role in multiple sclerosis," said study author Joseph Finkelstein, MD, PhD, of Johns Hopkins University School of Medicine, in Baltimore, MD, which conducted the study in collaboration with Veterans Affairs MS Center for Excellence. "Early smoking is an environmental factor that can be avoided." The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as multiple sclerosis, restless legs syndrome, Alzheimer's disease, narcolepsy, and stroke. For more information about the American Academy of Neurology, visit www.aan.com . The AAN 61st Annual Meeting, the world's largest gathering of neurology professionals, takes place April 25 to May 2, 2009, in Seattle. Visit www.aan.com/am for more information. Study authors are available for interviews. Please contact Jenine Anderson, janderson@aan.com or Jay Mac Bride, jmacbride@aan.com. To access 2009 AAN Annual Meeting abstracts available February 25, 2009, visit http://www.aan.com/go/science/abstracts. Late-breaking abstracts will be featured in press release at the 2009 AAN Annual Meeting in Seattle.

Multiple Sclerosis Associated with Lower Cancer Risk

ababb@aan.com — Mon, 30 Mar 2009 21:00:00 GMT

A new study shows that people with multiple sclerosis may be at a lower risk for cancer overall, but at a higher risk of developing certain types of cancer, such as brain tumors and bladder cancer. The study is published in the March 31, 2009, print issue of Neurology®, the medical journal of the American Academy of Neurology. Researchers looked at the medical records of 20,000 people with multiple sclerosis and 204,000 people without the diagnosis. After 35 years, they found that the people with MS had a decreased overall risk of cancer by 10 percent compared to people who did not have the disease. The result was more pronounced in women. However, for people with MS the risk for certain cancers, such as brain tumors and bladder and other urinary organ cancers, increased by up to 44 percent compared to people without MS. Scientists also evaluated the parents of people with MS to determine whether there was a possible genetic link. They found that there was no overall increased or decreased risk of cancer among either mothers or fathers of those with MS, compared to parents of people without MS. "We speculate that the lower risk for cancer among people with MS could be a result of lifestyle changes or treatment following diagnosis," said study author Shahram Bahmanyar, MD, PhD, of the Karolinska Institute in Sweden. "The increase in brain tumor diagnoses may be due to brain inflammation, but this finding may not reflect a real increase in cancer risk, as there is some evidence that more frequent neurological investigations in these patients mean that brain tumors are more likely to be found sooner. There may also be reasons related to the disease that could increase the risk for urinary organ cancers, resulting from chronic irritation to those organs as a result of MS. However, individual risk of developing urinary organ cancer is modest, as less than 0.2 percent of people with MS developed this cancer for every 10 years of follow-up." Bahmanyar also noted that people with MS have on average a lower body mass index (BMI) than the general population, and BMI is a risk factor for several types of cancer, so the lower body weight may explain some of the reduction in cancer risk. It is also possible that some reduction in cancer risk results from the way the body responds to MS. The study was supported by the Bibbi and Nils Jensens Foundation, the Montel Williams Foundation, the European Union's Sixth Framework Program NeuroproMiSe and the Swedish Association for Persons with Neurological Disabilities. The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as multiple sclerosis, restless legs syndrome, Alzheimer's disease, narcolepsy, and stroke. For more information about the American Academy of Neurology, visit www.aan.com.

Risk of Leukemia with Multiple Sclerosis Drug Higher Than Thought

ababb@aan.com — Thu, 30 Apr 2009 15:00:00 GMT

The risk of developing leukemia as a side effect of a drug for multiple sclerosis (MS) is higher than previously reported, according to a study to be presented as part of the Late-breaking Science Program at the American Academy of Neurology's 61st Annual Meeting in Seattle, April 25 - May 2, 2009. Mitoxantrone is an immunosuppressant drug approved by the FDA for treatment of several forms of advancing MS. It is one of only two drugs that has been shown to benefit people with secondary progressive MS who are having attacks. However, the drug can cause heart damage at high total doses. Due to this, the lifetime cumulative dose is equal to about eight to 12 doses over two to three years. Previous studies have also shown that the people with MS treated with the drug have an increased risk of developing leukemia. Those studies showed that acute leukemia occurred in .07 percent to .25 percent of MS patients taking mitoxantrone. Today's retrospective study of 2,854 Italian people with MS receiving the drug found that leukemia occurred in .74 percent. "This rate is significantly higher than what has been previously reported," said study author Vittorio Martinelli, MD, of University Vita-Salute in Milan, Italy. "The potential risk of leukemia should be carefully considered against the potential benefits of mitoxantrone treatment on every single patient." The study participants all had at least one cycle of mitoxantrone treatment and were observed for at least one year. A total of 21 people developed leukemia, eight of whom died. The people who developed leukemia had more treatment cycles than those who did not develop leukemia-8.6 cycles versus 7.2 cycles. They also had a greater cumulative dose of mitoxantrone. The leukemia occurred an average of three years after the first use of the drug and an average of 18 months after the end of treatment. "It is vital that all MS patients treated with mitoxantrone undergo prolonged and careful hematological follow-up to check for acute leukemia," Martinelli said. The American Cancer Society has estimated there were 44,270 new cases of leukemia in the general U.S. population last year. The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as multiple sclerosis, restless legs syndrome, Alzheimer's disease, narcolepsy, and stroke. For more information about the American Academy of Neurology, visit www.aan.com.

Adding Steroid Drug to MS Treatment May Reduce Disease Activity

ababb@aan.com — Thu, 30 Apr 2009 15:00:00 GMT

Using a steroid drug for multiple sclerosis (MS) in addition to an MS drug may reduce the amount of disease activity more than using the MS drug alone, according to a study that will be presented as part of the Late-breaking Science Program at the American Academy of Neurology's 61st Annual Meeting in Seattle, April 25 - May 2, 2009. For the study, people with MS received the steroid drug methylprednisolone in monthly "pulses," or three doses over three days, in addition to regular weekly treatment with the drug interferon beta-1a. The steroid drug has typically been used only to treat acute MS attacks, not as an ongoing treatment. The study involved 341 people with relapsing-remitting MS. Half of the participants received both drugs; half received only the interferon drug plus a placebo. The participants were seen every three months during the three-year study for evaluation. The participants had the disease for an average of three years and had not yet received a disease-modifying drug such as interferon. Those who received both drugs had 38 percent fewer relapses, or times when the disease is active, than those receiving only the interferon drug. They also improved slightly on a test of MS disability, while the scores for the placebo group decreased slightly. At the beginning of the study and again after three years, the researchers measured the size of lesions in the brain that are a sign of disease activity. For those receiving both drugs, the lesions stayed the same size or shrunk, while the size of the lesions grew for those taking only interferon. "These results indicate that these two drugs may have a synergy when taken together and provide a more beneficial effect on the disease activity," said study author Mads Ravnborg, MD, of the Danish Multiple Sclerosis Research Center at Copenhagen University Hospital in Denmark. "This is a promising finding, as the benefit from interferon is only moderate and not everyone responds fully to the treatment, so anything we can do to boost those results is positive." The study was supported by Biogen Idec. The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as multiple sclerosis, restless legs syndrome, Alzheimer's disease, narcolepsy, and stroke. For more information about the American Academy of Neurology, visit www.aan.com.

Cognitive Testing, Gender and Brain Lesions May Predict MS Disease Progression Risk

ababb@aan.com — Wed, 29 Jul 2009 21:00:00 GMT

Cognitive testing may help people with inactive or benign multiple sclerosis (MS) better predict their future with the disease, according to a study published in the July 29, 2009, online issue of Neurology®, the medical journal of the American Academy of Neurology. Gender and brain lesions may also determine the risk of progression of MS years after diagnosis. By current definition, people with benign MS are those who remain "fully functional" after 15 or more years from disease onset. However, people with benign MS occasionally develop renewed disease activity or progression, and can experience severe symptoms. For the study, researchers looked at the cognitive test results and brain scans of 63 people with benign MS during a period of five years. Of those, 43 were women and 20 were men. The cognitive tests included verbal and visual memory, attention, concentration and the speed at which the participant processed information. Brain scans revealed the number of lesions associated with MS on the person's brain. Follow-up neurologic exams were done every six months. The study found that nearly 30 percent of people with benign MS significantly worsened over the course of five years. People who failed more than two cognitive tests (out of 10 total) were 20 percent more likely to progress over time. Men with benign MS were nearly three times more likely to later experience signs of MS compared to women. People with more brain lesions detected on scans were also more likely to develop signs of the disease. "Our findings strongly suggest that a person's gender, cognitive state and amount of lesions on the brain are important factors for predicting MS progression," said study author Maria Pia Amato, MD, with the University of Florence in Italy. "Our study highlights the importance of cognitively testing people with benign MS who appear to be healthy. This information might be important in tailoring the patient's treatment." The study was supported by the Italian Multiple Sclerosis Association. The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer's disease, epilepsy, Parkinson's disease, and multiple sclerosis. For more information about the American Academy of Neurology, visit http://www.aan.com or www.thebrainmatters.org.

Smoking Linked to Increased Brain Lesions and Brain Shrinkage in MS

ababb@aan.com — Mon, 17 Aug 2009 21:00:00 GMT

EMBARGOED FOR RELEASE UNTIL 4 P.M. ET, MONDAY, AUGUST 17, 2009 Media Contacts: Rachel Seroka, rseroka@aan.com, (651) 695-2738 Angela Babb, ababb@aan.com, (651) 695-2789 Smoking Linked to Increased Brain Lesions and Brain Shrinkage in MS ST. PAUL, Minn. -People who smoke and have multiple sclerosis (MS) may be at increased risk of brain shrinkage and increased brain lesions related to the disease, according to a study published in the August 18, 2009, print issue of Neurology®, the medical journal of the American Academy of Neurology. Smoking has already been linked to an increased risk of developing MS. Researchers studied 368 people in New York with an average age of 44 who had been diagnosed with MS for an average of 12 years. Participants underwent brain scans and were asked about their smoking history. Of the group, 240 were non-smokers, 96 were current smokers and 32 were past smokers. Current smokers were considered people who smoked more than 10 cigarettes per day in the three months leading up to the study and past smokers were those who smoked for at least six months sometime before the start of the study. The average current smoker in the study had been smoking for 18 years. The study found that smokers with MS had a greater breakdown of the barrier between the brain and blood and had nearly 17 percent more brain lesions on their scans compared to non-smokers with MS. Smokers with MS had 13 percent larger ventricles and a smaller brain size compared to non-smokers with MS. "These results show that smoking appears to quite literally injure the brain in a person with multiple sclerosis and increases the risk of disease severity and progression," said study author Robert Zivadinov, MD, PhD, Associate Professor with State University of New York School of Medicine and Biomedical Sciences in Buffalo. Zivadinov is also the Director of the Buffalo Neuroimaging Analysis Center, the Jacobs Neurological Institute and a member of the American Academy of Neurology. "Our study stresses the importance of anti-smoking education in schools, where many smokers start, and more targeted programs to help people with MS to quit smoking so they can have a better quality of life." The study also found that smokers were likely to have more problems with motor functioning, such as walking and taking part in daily activities, than non-smokers. The study was supported by the National Multiple Sclerosis Society. The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Parkinson's disease, ALS (Lou Gehrig's disease), dementia, West Nile virus, and ataxia. For more information about the American Academy of Neurology, visit http://www.aan.com or www.thebrainmatters.org.

Cigarettes, Not Swedish Snuff Linked to Increased Risk of MS

ababb@aan.com — Mon, 31 Aug 2009 21:00:00 GMT

While smoking cigarettes appears to significantly increase a person's risk of developing multiple sclerosis, using Swedish snuff does not, according to a study published in the September 1, 2009, print issue of Neurology®, the medical journal of the American Academy of Neurology. "While tobacco cigarettes increased a person's risk of developing MS, our research found that using Swedish snuff was not associated with an elevated risk for MS," said study author Anna Hedström, MD, of the Swedish medical university Karolinska Institutet in Stockholm."These results could mean that nicotine is not the substance responsible for the increased risk of MS among smokers." The study involved 902 people diagnosed with MS and 1,855 people without MS in Sweden between the ages of 16 and 70. All participants answered a questionnaire about tobacco cigarettes and snuff use. The researchers found that in women who smoked, the risk for developing MS was nearly one and a half times higher than in women who did not smoke. In men, the risk was nearly two times higher in those who smoked compared to those who did not smoke. This was the case even in people who only smoked moderately. The risk remained high for up to five years after the participant stopped smoking and the risk climbed the more a person smoked. However, the study also found that people who used Swedish snuff for more than 15 years were 70 percent less likely to develop MS than those who had never used any type of tobacco. However, there was no significant effect of snuff-taking for less than 15 years, a period during which other adverse consequences of taking snuff, including head-and-neck cancer, would become evident. Swedish snuff differs from snuff commonly used in the United States in that it is typically a moist powder that usually does not result in a need for spitting. "Taking snuff, however, may have other harmful effects, and our findings should not be interpreted to mean that Swedish snuff is recommended to prevent disease," said Hedstrom. "More research is needed to better understand the mechanisms behind the findings. Theories are that smoking may raise the risk of MS by increasing the frequency and persistence of respiratory infections, or by causing autoimmune reactions in genetically susceptible people." The study was supported by The Swedish Medical Research Council, the Swedish Council for Working Life and Social Research, the European Union's Sixth Framework Program NeuroproMiSe, Bibbi and Niels Jensens Foundation, Montel Williams Foundation and the Söderberg Foundation. The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer's disease, epilepsy, Parkinson's disease, and multiple sclerosis. For more information about the American Academy of Neurology, visit http://www.aan.com or www.thebrainmatters.org

What Part Do Relapses Play in Severe Disability for People with MS?

ababb@aan.com — Wed, 04 Nov 2009 22:00:00 GMT

People with multiple sclerosis (MS) who have relapses within the first five years of onset appear to have more severe disability in the short term compared to people who do not have an early relapse, according to a new study published in the November 4, 2009, issue of Neurology® , the medical journal of the American Academy of Neurology. The study is one of the first to examine how MS relapses affect people during different time periods of the disease. Research shows that 85 percent of people with MS begin by having the relapsing-remitting form of the disease and the majority of these people later develop secondary progressive MS. A relapse is defined in the study as worsening of neurological symptoms for more than 24 hours, without a fever or infection. Because relapse-related symptoms often improve within a few weeks, it's been unclear how much disability comes from relapses, and how much from progression. For the study, scientists reviewed the medical records of 2,477 people with MS who experienced relapses in British Columbia, Canada. The study looked at whether the participants had disability severe enough to require the use of a cane for walking and whether this was related to relapses occurring within five years, five to 10 years, or more than 10 years after onset of symptoms. The participants were followed for an average of 20 years. During that time, the group experienced 11,722 relapses. Scientists found that people who had a relapse within five years of disease onset were at a 48 percent higher hazard (a measure of relative risk) of needing a cane to walk within five years of disease onset than those who did not have an early relapse. Importantly, the impact of the early relapse lessened over time. Those with early relapse who did not need a cane after five years were at only a 10 percent higher hazard (a measure of relative risk) of needing one 10 years after disease onset than those without early relapses. "Our findings may represent an important message to people diagnosed with MS today. Those who have a history of relapses could potentially be offered reassurance that as time goes on, these relapses will have a diminishing effect on their everyday lives," said study author Helen Tremlett, PhD, with the University of British Columbia in Vancouver. "In addition, our study calls upon the need for new medications that target axonal degeneration, which is suspected of causing permanent disability, especially for people who have had MS for many years or who are older at diagnosis." The impact of relapses that occurred later, either at five to 10 or more than 10 years after the start of the disease, also waned over time and became insignificant after long-term follow up. Relapses in people under 25 had a longer impact on disability compared to those over 35 years. "There may be a longer window of opportunity for treating younger people with MS right away, changing the course of progression later on," Tremlett said. The study was supported by the U. S. National MS Society. The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer's disease, epilepsy, Parkinson's disease, and multiple sclerosis. For more information about the American Academy of Neurology, visit AAN Website or TheBrainMatters.org Website. VIDEO: www.youtube.com/AANChannel TEXT: www.aan.com/press TWEETS: www.twitter.com/AANPublic

Teenage Obesity Linked to Increased Risk of MS

ababb@aan.com — Mon, 09 Nov 2009 22:00:00 GMT

EMBARGOED FOR RELEASE UNTIL 4 P.M. ET, MONDAY, NOVEMBER 9, 2009 Media Contacts: Rachel Seroka, rseroka@aan.com, (651) 695-2738 Angela Babb, ababb@aan.com, (651) 695-2789 Teenage Obesity Linked to Increased Risk of MS ST. PAUL, Minn. -Teenage women who are obese may be more than twice as likely to develop multiple sclerosis (MS) as adults compared to female teens who are not obese, according to a study published in the November 10, 2009, print issue of Neurology®, the medical journal of the American Academy of Neurology. The research involved 238,371women from the Nurses' Health Study and Nurses' Health Study II who were 25 to 55 years old. The women answered a questionnaire about their health behavior and medical information every two years. Over the course of 40 years, 593 developed MS. Participants reported their weight and height at age 18. Scientists then calculated their body mass index (BMI). The women were also asked to choose one of nine body silhouettes, ranging from very thin to extremely obese, to describe their body size at five, 10 and 20 years old. The study found that women who had a BMI of 30 or larger at age 18 had more than twice the risk of developing MS compared to those with a BMI between 18.5 and 20.9. A woman with a BMI of 25 to 29.9 kilograms per meter squared was considered overweight whereas a woman who was considered obese had a BMI of 30 or more kilograms per meter squared. The disease risk among women who were overweight but not obese at age 18 was only somewhat increased. The results were the same after accounting for smoking status and physical activity level. Women who had a larger body size at 20 years of age, represented by the use of silhouettes in the study, also had twice the risk of MS compared to women who reported a thinner body size. Larger body sizes at ages 5 and 10 were not associated with MS risk. "Our results suggest that weight during adolescence, rather than childhood or adulthood, is critical in determining the risk of MS," said study author Kassandra Munger, ScD, of Harvard School of Public Health in Boston. "Teaching and practicing obesity prevention from the start, but especially during teenage years, may be an important step in reducing the risk of MS later in life for women." Munger said there are two possible explanations why obesity may affect MS risk. Higher levels of vitamin D in the body are thought to reduce disease risk. People who are obese tend to have lower vitamin D levels compared to people who are not obese. In addition, fatty tissue produces substances that affect the immune system and certain types of cell activities that are thought to be associated with MS. The study was supported by the National Institute of Neurological Disorders and Stroke. The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer's disease, epilepsy, Parkinson's disease, and multiple sclerosis. For more information about the American Academy of Neurology, visit AAN.comor TheBrainMatters.org. VIDEO: http://www.youtube.com/AANChannel TEXT: http://www.aan.com/press TWEETS: http://www.twitter.com/AANPublic

Good News on Multiple Sclerosis and Pregnancy

ababb@aan.com — Wed, 18 Nov 2009 22:00:00 GMT

There is good news for women with multiple sclerosis (MS) who are pregnant or thinking about becoming pregnant. A new study shows that pregnant women with multiple sclerosis are only slightly more likely to have cesarean deliveries and babies with a poor prenatal growth rate than women who do not have MS. Plus, the women with MS were no more likely to have other pregnancy problems, such as preeclampsia and other high blood pressure problems and premature rupture of membranes, than women in the general population. The study is published in the November 18, 2009, online issue of Neurology®, the medical journal of the American Academy of Neurology. The large study used a national database from all non-federal short-stay hospitals in 38 states. The data included an estimated 18.8 million deliveries, with about 10,000 of those occurring in women with MS. The women with MS were more likely than women without chronic medical conditions (2.7 percent for women with MS compared to 1.9 percent for women without chronic medical conditions) to have a fetus with intrauterine growth restriction, defined as a weight less than the tenth percentile for the gestational age, as measured by ultrasound. Women with MS were more likely to have a cesarean delivery than those in the general population (42 percent versus 33 percent). "These results are reassuring for women with MS," said study author Eliza Chakravarty, MD, MS, of Stanford University School of Medicine in Stanford, CA. "Women and their doctors have been uncertain about the effect of MS on pregnancy, and some women have chosen to delay or even avoid pregnancy due to the uncertainty. We found that women with MS did not have an increased risk of most pregnancy complications." Chakravarty said that previous studies on MS and pregnancy have focused on the impact of pregnancy on disease activity. The study also looked at women who had diabetes prior to becoming pregnant (not gestational diabetes), and found that they had higher rates of complications than women with MS and high rates of complications in areas where the women with MS did not have increased rates. The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer's disease, epilepsy, Parkinson's disease, and multiple sclerosis. For more information about the American Academy of Neurology, visit http://www.aan.com or http://www.thebrainmatters.org. VIDEO: http://www.youtube.com/AANChannel TEXT: http://www.aan.com/press TWEETS: http://www.twitter.com/AANPublic