Background
Multiple sclerosis (MS) is a complex inflammatory disease in which demyelination occurs in the central nervous system affecting approximately 2.5 million people worldwide. Intestinal ...microbiome changes play an important role in the etiology of chronic diseases.
Objective
This study aimed to investigate the effect of probiotic supplementation on systemic inflammation in patients with MS.
Methods
A 12-week double-blind clinical trial study was designed and seventy patients with MS were randomly divided into two groups receiving probiotics and placebo. Patients in the intervention group received two capsules containing multi-strain probiotics daily and patients in the control group received the same amount of placebo. Factors associated with systemic inflammation were assessed at the beginning and end of the study.
Results
Sixty-five patients were included in the final analysis. There was no significant difference between the two groups in terms of baseline variables except for the duration of the disease (
P
> 0.05). At the end of the study, probiotic supplementation compared to the placebo caused a significant reduction in the serum levels of CRP (−0.93 ± 1.62 vs. 0.05 ± 1.74,
P
= 0.03), TNF-α (−2.09 ± 1.88 vs. 0.48 ± 2.53,
P
= 0.015) and IFN-γ (−13.18 ± 7.33 vs. −1.93 ± 5.99,
P
< 0.001). Also, we found a significant increase in the FOXP3 and TGF-β levels in the intervention group (
P
< 0.05).
Conclusion
The results of our study showed that supplementation with probiotics can have beneficial effects on serum levels of some factors associated with systemic inflammation.
Clinical trial registration
http://www.irct.ir
, identifier IRCT20181210041 918N1.
Overactive bladder (OAB) is one of the most common complications in patients with multiple sclerosis (MS). Choosing the effective treatment is very important in improving their quality of life (QOL). ...Therefore, the aim of this study was to compare solifenacin (SS) and posterior tibial nerve stimulation (PTNS) treatment effects in the MS Patients with OAB.
In total, 70 MS patients suffering from OAB enrolled in this clinical trial study. Patients with a score of at least 3 according to the OAB questionnaire were randomly divided into two groups (35 patients in each group). In one group, patients received SS (5 mg daily for 4 weeks and 10 mg/day for another 8 weeks) and in a second group, patients were treated by PTNS (12 weekly session, 30 min).
The mean (SD) age of patients participating in this study was 39.82 (9.088) and 42.41 (9.175) years for the SS group and the PTNS group, respectively. Patients in both groups showed statistically significant improvements in urinary incontinence, micturition, and daytime frequency (
< 0.001). Patients in the SS group had a better response for urinary incontinence after 12 weeks compared to the PTNS group. Also, patients in the SS group reported higher satisfaction and less daytime frequency compared to the PTNS group.
SS and PTNS were effective for improving the OAB symptoms in patients with MS. However, patients demonstrated a better experience with SS in terms of daytime frequency, urinary incontinence, and treatment satisfaction rate.
Aim
N‐acetylcysteine (NAC), a thiol‐containing antioxidant and glutathione (GSH) precursor, attenuates oxidative stress, and possibly improves psychiatric disorders. This study aimed to evaluate the ...effects of oral NAC on oxidative stress, depression, and anxiety symptoms in patients with multiple sclerosis (MS).
Methods
This clinical trial was conducted on 42 MS patients randomly assigned to intervention (n = 21) and control (n = 21) groups. The intervention group received 600 mg of NAC twice daily for 8 weeks, and the control group received a placebo with the same prescription form. An analysis of serum malondialdehyde (MDA), serum nitric oxide (NO), and erythrocyte GSH was carried out on both groups, along with a complete blood count. The Hospital Anxiety and Depression Scale (HADS) was used to assess symptoms of depression (HADS‐D) and anxiety (HADS‐A).
Results
Compared to the control group, NAC consumption significantly decreased serum MDA concentrations (−0.33 −5.85–2.50 vs. 2.75 −0.25–5.22 μmol/L; p = 0.03) and HADS‐A scores (−1.6 ± 2.67 vs. 0.33 ± 2.83; p = 0.02). No significant changes were observed in serum NO concentrations, erythrocyte GSH levels, and HADS‐D scores (p > 0.05).
Conclusions
Based on the findings of the present study, NAC supplementation for 8 weeks decreased lipid peroxidation and improved anxiety symptoms in MS patients. The aforementioned results suggest that adjunctive therapy with NAC can be considered an effective strategy for MS management. Further randomized controlled studies are warranted.
N‐acetylcysteine (NAC) supplementation for 8 weeks decreased lipid peroxidation and improved anxiety symptoms in multiple sclerosis (MS) patients. The aforementioned results suggest that adjunctive therapy with NAC can be considered an effective strategy for MS management.
There is no study in the world on the relationship between consuming black and green tea as beverages containing polyphenols and the risk of MS. This study aimed to determine the association between ...the consumption of green and black tea, coffee, non-alcoholic beer, milk, fruit juices and carbonated beverages with the risk of MS.
This case-control study was performed on 150 patients with MS and 300 healthy individuals as a control group among patients who were referred to the ophthalmology ward of a referral hospital in Ahvaz with the groups matching for age. The data collection tool was a researcher-made questionnaire including demographic information and beverage consumption. Analysis was performed using univariate and multiple logistic regression models.
The mean age of patients at the time of diagnosis was 38.55 ± 8.88 years. The results showed that drinking milk (OR = 5.46), natural juice (OR = 2.49), and carbonated beverages (OR = 16.17) were associated with an increased chance of developing MS. However, drinking non-alcoholic beer (OR = 0.48), black tea (OR = 0.20), green tea (OR = 0.29) and coffee (OR = 0.07) were associated with a reduced chance of developing MS.
The results show that drinking black and green tea, non-alcoholic beer, and coffee are associated with a decrease in the chance of developing MS. The results of this study can be used to design interventional research and to change people's lifestyles to prevent MS.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Background: The prevalence and incidence of Multiple Sclerosis (MS) have increased in Iran. Objectives: This study aimed to observe the temporal trends and provide a predictive model in the ...prevalence and incidence of MS in Khuzestan Province, Iran. Materials & Methods: This cross-sectional study was performed from 2006 to 2019 in Khuzestan Province, Southwestern Iran, on 2676 patients registered in the Khuzestan Multiple Sclerosis Center. The simple exponential smoothing model was used to study the time trends and predict the prevalence and incidence of MS in 2020. Results: The mean±SD age of the examined patients with MS was 31.40±8.94 years; while the mean±SD age-incidence of MS was 29.19±9.16 years. The sex ratio (female to male) was measured as 3.05. The patients’ prevalence and average annual incidences were 57.77 and 4.35per 100000 individuals from 2006 to 2019, respectively. The trend in the MS incidence has been upward with a very slight slope during the years 2006 to 2019. The slope of the increase from 2006 to 2019 was higher for women than men. Conclusion: The collected results suggested that Khuzestan Province is a high-risk area for MS; the prevalence and incidence of the disease are increasing, especially in women. We prognosticate a slight increase in the incidence of MS in the age group of 20 to 50 years. However, the prevalence of the disease in this age group was similar to 2019.
Background:
Several natural history studies on primary progressive multiple sclerosis (PPMS) patients detected a consistent heterogeneity in the rate of disability accumulation.
Objectives:
To ...identify subgroups of PPMS patients with similar longitudinal trajectories of Expanded Disability Status Scale (EDSS) over time.
Methods:
All PPMS patients collected within the MSBase registry, who had their first EDSS assessment within 5 years from onset, were included in the analysis. Longitudinal EDSS scores were modeled by a latent class mixed model (LCMM), using a nonlinear function of time from onset. LCMM is an advanced statistical approach that models heterogeneity between patients by classifying them into unobserved groups showing similar characteristics.
Results:
A total of 853 PPMS (51.7% females) from 24 countries with a mean age at onset of 42.4 years (standard deviation (SD): 10.8 years), a median baseline EDSS of 4 (interquartile range (IQR): 2.5–5.5), and 2.4 years of disease duration (SD: 1.5 years) were included. LCMM detected three different subgroups of patients with a mild (n = 143; 16.8%), moderate (n = 378; 44.3%), or severe (n = 332; 38.9%) disability trajectory. The probability of reaching EDSS 6 at 10 years was 0%, 46.4%, and 81.9% respectively.
Conclusion:
Applying an LCMM modeling approach to long-term EDSS data, it is possible to identify groups of PPMS patients with different prognosis.
Migraine is a painful and disabling nervous disorder which negatively affects the quality of life. Migraineurs may suffer from a generalized vasomotor dysfunction. Statins improve vasomotor and ...vascular function, with their pleiotropic effects. We aimed to assess efficacy and safety of adding Atorvastatin to prophylactic regimen in better control of migraine with aura.
This triple-blind controlled clinical trial was on 68 patients with migraine with aura. An interval of at least 1 month was given to evaluate vitamin D3 level and eligibility. In patients with vitamin D3 deficiency, the correction with vitamin D supplementation was provided. The patients were randomly assigned to receive atorvastatin 20 mg plus sodium valproate 500 mg or placebo plus sodium valproate 500 mg once a day for 2 months. The patients were evaluated based for the number of attacks and pain severity based on Visual Analogue Scale.
There was a significant (p = 0.0001) improvement in severity of pain and number of migraine attacks by adding Atorvastin to the prophylactic regimen of patients with migraine with aura. After controlling for variable parameters, the differences between two arms of the study was yet statistically significant (p = 0.0001). A significant number of participants in intervention group were satisfied by their treatment (p = 0.001) with no remarkable side effects (P = 0.315).
Adding atorvastatin to migraine with aura preventive regimen may help reduce the number of acute attacks and pain severity without causing considerable side effects and led to a better patient satisfaction.
IRCT20180106038242N1 . Registered: 7 February 2018.
•Only 12 studies was found of which 10 studies focused on cytokines, 1 study focused on adipokines, and 1 study included both cytokines and adipokines.•There is no strong evidence that confirms a ...positive or negative effect of exercise on cytokine or adipokine in MS patients, yet this research in plagued by methodological weaknesses.•In relation to cytokines or adipokines, no studies reported harmful effects of exercise.•Regular physical activity did not lead to an increase in pro-inflammatory cytokines or adipokines as well as disease severity.
Physical activity, particularly exercise training, is an evidence-based approach for managing symptoms, restoring function and improving overall wellness in people with multiple sclerosis (MS). Several recent studies have argued for a potential disease modifying effect of exercise in people with MS, and among the potential mediating mechanisms are exercise training effects on both cytokines and adipokines. The objectives of this study were to perform a systematic review of exercise training effects on cytokine and adipokine profiles in persons with MS.
We conducted open-dated searches of PubMed, Cochrane Library, EMBASE and PEDro using the terms ‘Multiple sclerosis’ or ‘MS’ AND ‘exercise’ OR ‘training’ OR ‘physical activity’ AND ‘cytokine’ OR ‘inflammatory’ OR ‘immune’ OR ‘adipokine’. Included studies were written in English; comprised of humans with MS, and evaluated the effects of regular physical activity or exercise on pro-inflammatory, anti-inflammatory cytokines or adipokines. Two authors independently scanned titles and abstracts, and read the studies included. All studies were rated on the PEDro scale and further classified based on American Academy of Neurology criteria.
Twelve studies were included of which 10 studies focused on cytokines, 1 study focused on adipokines, and 1 study included both cytokines and adipokines. The selected studies included 3 Class I studies, 7 Class II studies, and 2 Class IV studies and had average PEDro scores of 6.9 ± 1.6. Studies included endurance (n = 5), resistance (n = 3), combined (n = 3), and vibration (n = 1) training. Overall, there is a general lack of standardization of procedures across studies and inconsistent evidence for the effects of physical activity and exercise on cytokine and adipokine profiles in MS, with a general pattern indicating a lack of effect.
Research regarding the effects of exercise training on cytokines and adipokines in MS is in its infancy, but exercise represents an adjuvant therapy in MS, and future studies are essential for clarifying the role of exercise on cytokines and adipokines in MS.
No previous studies have assessed the psychometric properties of the 36-item version of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in the Persian language of Iran. ...This study was designed and conducted to evaluate the validity and reliability of the Persian version using a sample of persons with multiple sclerosis in Ahvaz, Iran.
The methodological study was conducted in two stages: First, the 36 items of the original WHODAS 2.0 were translated to create a Persian version, after which the translation validity and psychometric properties were tested. The factor structure of the instrument was also tested using exploratory and confirmatory factor analyses.
The intraclass correlation coefficients were very good to excellent, varying between 0.82 and 0.99 for the six domains, and all domains had Cronbach's α reliability values of above 0.70. For construct validity, results showed negative and strong correlation between the total score of WHODAS 2.0 and the Multiple Sclerosis Quality of Life-54. Exploratory factor analysis divided the Persian version of WHODAS 2.0 into seven factors for multiple sclerosis patients.
The results of this study indicate that the Persian version of WHODAS 2.0 is a valid and reliable instrument to study the disabilities of people with multiple sclerosis.
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