Background: Many persons with multiple sclerosis (PwMS) report increased fatigue in the afternoon and evening compared with the morning. It is commonly accepted that physical capacity also decreases ...as time of day progresses, potentially influencing the outcomes of testing.
Objective: The objective of this article was to determine whether self-reported fatigue level and walking capacity are influenced by time of day in PwMS.
Methods: A total of 102 PwMS from 8 centers in 5 countries, with a diverse level of ambulatory dysfunction (Expanded Disability Status Scale EDSS <6.5), participated. Patients performed walking capacity tests and reported fatigue level at three different time points (morning, noon, afternoon) during 1 day. Walking capacity was measured with the 6-Minute Walk Test (6MWT) and the 10-m walk test performed at usual and fastest speed. Self-reported fatigue was measured by the Rochester Fatigue Diary (RFD). Subgroups with mild (EDSS 1.5–4.0, n = 53) and moderate (EDSS 4.5–6.5, n = 49) ambulatory dysfunction were formed, as changes during the day were hypothesized to depend on disability status.
Results: Subgroups had different degree of ambulatory dysfunction (p < 0.001) but reported similar fatigue levels. Although RFD scores were affected by time of day with significant differences between morning and noon/afternoon (p < 0.0001), no changes in walking capacity were found in any subgroup. Additional analyses on subgroups distinguished by diurnal change in self-reported fatigue failed to reveal analogous changes in walking capacity.
Conclusions: Testing of walking capacity is unaffected by time of day, despite changes in subjective fatigue.
Background
Trigeminal‐mediated headshaking results from low‐threshold firing of the trigeminal nerve resulting in apparent facial pain. Magnesium may have neuroprotective effects on nerve firing that ...potentially dampen signs of neuropathic pain. This hypothesis has not been investigated in horses with trigeminal‐mediated headshaking.
Objective
To investigate head‐shaking behavior in affected horses after IV magnesium sulfate infusion.
Animals
Six geldings with trigeminal‐mediated headshaking.
Methods
Prospective randomized crossover study. Horses were controlled for diet and infused IV with 5% dextrose solution (DS; control solution at 2 mL/kg body weight BW) and MgSO4 50% solution (MSS at 40 mg/kg BW). Head‐shaking behavior was recorded at times T0 (baseline, before infusion) and T15, T30, T60, and T120 minutes post‐infusion. Venous blood variables such as pH, HCO3−, standard base excess (SBE), Na+, Cl−, K+, Ca2+, Mg2+, total magnesium (tMg), glucose, and lactate were measured; strong ion difference (SID) and anion gap (AG) were calculated for each time point.
Results
Blood variables including pH, Na+, Cl−, K+, SID, AG, lactate, Ca2+, tMg, and Mg2+ had significant changes with MSS as compared to DS treatment. Glucose, SBE, and HCO3− did not have significant changes. A 29% reduction in head‐shaking rate occurred after MSS treatment but no change occurred after DS treatment.
Conclusions and Clinical Importance
Administration of MSS IV increased plasma total and ionized magnesium concentrations and significantly decreased head‐shaking behavior in horses with trigeminal‐mediated headshaking.
The relationship between fatigue impact and walking capacity and perceived ability in patients with multiple sclerosis (MS) is inconclusive in the existing literature. A better understanding might ...guide new treatment avenues for fatigue and/or walking capacity in patients with MS.
To investigate the relationship between the subjective impact of fatigue and objective walking capacity as well as subjective walking ability in MS patients.
A cross-sectional multicenter study design was applied. Ambulatory MS patients (n = 189, age: 47.6 ± 10.5 years; gender: 115/74 women/men; Expanded Disability Status Scale (EDSS): 4.1 ± 1.8 range: 0–6.5) were tested at 11 sites. Objective tests of walking capacity included short walking tests (Timed 25-Foot Walk (T25FW), 10-Metre Walk Test (10mWT) at usual and fastest speed and the timed up and go (TUG)), and long walking tests (2- and 6-Minute Walk Tests (MWT). Subjective walking ability was tested applying the Multiple Sclerosis Walking Scale-12 (MSWS-12). Fatigue impact was measured by the self-reported modified fatigue impact scale (MFIS) consisting of a total score (MFIStotal) and three subscales (MFISphysical, MFIScognitive and MFISpsychosocial). Uni- and multivariate regression analysis were performed to evaluate the relation between walking and fatigue impact.
MFIStotal was negatively related with long (6MWT, r = −0.14, p = 0.05) and short composite (TUG, r = −0.22, p = 0.003) walking measures. MFISphysical showed a significant albeit weak relationship to walking speed in all walking capacity tests (r = −0.22 to −0.33, p < .0001), which persisted in the multivariate linear regression analysis. Subjective walking ability (MSWS-12) was related to MFIStotal (r = 0.49, p < 0.0001), as well as to all other subscales of MFIS (r = 0.24–0.63, p < 0.001), showing stronger relationships than objective measures of walking.
The physical impact of fatigue is weakly related to objective walking capacity, while general, physical, cognitive and psychosocial fatigue impact are weakly to moderately related to subjective walking ability, when analysed in a large heterogeneous sample of MS patients.
•Despite being equally prevalent symptoms in MS the relation between gait impairments and fatigue is unclear.•General fatigue impact is not related to most walking outcomes in MS.•The physical impact of fatigue is weak to moderately related to both objective and subjective walking capacity in MS.
Background
Trigeminal‐mediated headshaking results from a low threshold for firing of the trigeminal nerve. A seasonal component has been implicated in onset of clinical signs, which occur during the ...spring and summer months. Geldings are overrepresented in the affected population and hormonal differences as compared to a healthy control population of geldings might contribute to headshaking.
Objective/Hypothesis
To assess concentrations of luteinizing hormone (LH) over an 8‐hour period in gelded healthy controls and horses affected with headshaking. Our hypothesis was that geldings with seasonal headshaking would have higher concentrations of LH over an 8‐hour period compared to control horses during the summer when affected horses manifested headshaking.
Animals
Twelve geldings (6 controls and 6 affected).
Methods
Prospective controlled trial. Blood samples were drawn every 15 minutes over an 8‐hour time period during summer from all horses to measure circulating LH concentrations by using a radioimmunoassay for equine LH. All affected horses were actively affected by headshaking at the time of sample collection.
Results
No statistically significant differences in LH concentrations were found throughout the study period in headshakers as compared to control horses. Time had no significant effect, but a slight decrease in LH concentrations was observed for all horses. The main limitation of the study was the low number of horses.
Conclusions and Clinical Importance
Horses affected with headshaking did not have significant differences in circulating LH during the late summer as compared to control horses.
To examine the aerobic intensity level and pacing pattern during the 6-min walk test (6MWT) in persons with multiple sclerosis, taking into account time of day, fatigue, disability level and multiple ...sclerosis subtype.
Cross-sectional study.
Eighty multiple sclerosis patients (Expanded Disability Status Scale, EDSS ≤ 6.5).
Participants performed the 6MWT at 3 different time-points (morning, noon, afternoon) during 1 day. Heart rate and pacing strategy (distance covered every minute) were registered. A sub-group analysis determined the effects of fatigue, disability level and multiple sclerosis subtype.
The relative aerobic intensity was constant throughout the day (67 ± 10% of estimated maximal heart rate). In all sub-groups heart rate increased and distance walked declined after the first minute (p < 0.001). The mild EDSS sub-group showed a slightly larger increase throughout the 6MWT in heart rate development, while no differences were seen in sub-groups of fatigue and multiple sclerosis subtype. In most sub-groups walking speed was fastest in the first minute and constant during the final 4 minutes.
In patients with multiple sclerosis aerobic intensity is moderate during the 6MWT and unaffected by time of day. Disability may have some influence on aerobic intensity, but not on pacing strategy during the 6MWT, whereas neither fatigue nor multiple sclerosis subtype has any effect.
Lactobacillus fermentum Ogi E1 is an amylolytic heterofermentative lactic acid bacterium previously isolated from ogi, a Benin maize sourdough. In the present study, the effect of different pH ...between 3.5 and 6.0 on starch fermentation products and α-amylase production was investigated. Whereas a pH of 5.0 was optimum for specific growth rate and lactic acid production, growth was only slightly affected at suboptimal pH of 4.0 and 6.0. Over a pH range of 6.0 to 3.5, yields of product formation from substrate and of biomass relative to ATP were constant. These results showed that
L. fermentum Ogi E1 was particularly acid tolerant, and well adapted to the acid conditions that develop during natural fermentation of cereal doughs. This acid tolerance may partly explain the dominance of
L. fermentum in various traditional African sourdoughs. Surprisingly, α-amylase production, unlike growth, dropped dramatically when the strain was cultivated at pH 4.0 with starch. With maltose as substrate, the yield of α-amylase relative to biomass remained unchanged at pH 4.0 and 5.0, unlike that observed with starch. Based on the distribution of enzyme activity between extra- and intracellular fractions and fermentation kinetics, it appears that starch was first hydrolyzed into dextrins by α-amylase activity, and maltose was produced from dextrins by extracellular enzyme activity, transferred into the cell and then hydrolyzed into glucose by intracellular α-glucosidase.
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