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Ghoshouni H, Rafiei N, Yazdan Panah M, Dehghani Firouzabadi D, Mahmoudi F, Asghariahmadabad M, Shaygannejad V, Mirmosayyeb O. Asthma and chronic obstructive pulmonary disease (COPD) in people with multiple sclerosis: A systematic review and meta-analysis. Mult Scler Relat Disord 2024; 85:105546. [PMID: 38507873 DOI: 10.1016/j.msard.2024.105546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 02/25/2024] [Accepted: 03/07/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Studies have found that multiple sclerosis (MS) has an impact on the initiation or the course of asthma and chronic obstructive pulmonary disease (COPD). This review amied to investigate the prevalence and odds of asthma and COPD among people with MS (pwMS). METHOD PubMed, Embase, Scopus, and Web of Science were systemically searched from inception to May 2023. R version 4.3.2 and random-effect model were used to calculate the pooled prevalence and odds ratio (OR), with their 95 % confidence interval (CI), in pwMS. RESULTS A total of 40 studies consisting of 287,702 pwMS were included. 37 studies indicated that the pooled prevalences of asthma and COPD among pwMS were 5.97 % (95 % CI: 4.62 %-7.69 %, I2=99 %) and 3.03 % (95 % CI: 1.82 %-5.00 %, I2=99 %), respectively. 24 studies on 236,469 pwMS and 85,328,673 healthy controls revealed that the overall odds of asthma and COPD in MS were 1.14 (95 % CI: 0.76-1.71, p-value=0.53, I2=97 %) and 1.28 (95 % CI: 1.11-1.47, p-value<0.01, I2=70 %), respectively. CONCLUSION MS can increased the risk of developing COPD, while asthma does not exhibit a significant relationship with MS. Our study highlights the importance of identifying pwMS who face greater risks of respiratory issues to monitor efficiently and initiate suitable preventative actions.
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Affiliation(s)
- Hamed Ghoshouni
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nazanin Rafiei
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Yazdan Panah
- Students Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | | | - Farhad Mahmoudi
- Department of Neurology, University of Miami, Miami, FL 33136, USA
| | - Mona Asghariahmadabad
- Department of Neurological Surgery, University of California, San Francisco, California, USA
| | - Vahid Shaygannejad
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Neurology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Omid Mirmosayyeb
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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Murrieta-Álvarez I, A Fernández-Gutiérrez J, A Pérez C, León-Peña AA, Reyes-Cisneros ÓA, Benítez-Salazar JM, Sánchez-Bonilla D, Olivares-Gazca JC, Fernández-Lara D, Pérez-Padilla R, Ruiz-Delgado GJ, Ruiz-Argüelles GJ. Impaired lung function in multiple sclerosis: a single-center observational study in 371 persons. Neurol Sci 2023; 44:4429-4439. [PMID: 37410269 DOI: 10.1007/s10072-023-06914-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 06/15/2023] [Indexed: 07/07/2023]
Abstract
INTRODUCTION Abnormal lung function in people with multiple sclerosis (PwMS) could be considered as the result of muscle weakness or MS-specific structural central nervous system (CNS) abnormalities as a precipitant factor for the worsening of motor impairment or cognitive symptoms. METHODS This is a cross-sectional observational study in PwMS. Forced spirometry was conducted, and normative metrics of forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and the relation FEV1/FVC were calculated. Qualitative and quantitative brain magnetic resonance imaging (MRI) examinations were carried out. RESULTS A total of 371 PwMS were included in the study. Of those, 196 (53%) had RRMS, 92 (25%) SPMS, and 83 (22%) PPMS. Low FVC and FEV1 was present in 16 (8%), 16 (19%), and 23 (25%) of the patients in the RRMS, PPMS, and SPMS, respectively. PwMS with T2-FLAIR lesions involving the corpus callosum (CC) had a significantly higher frequency of abnormally low FVC and FEV1 (OR 3.62; 95% CI 1.33-9.83; p = 0.012) than patients without lesions in that region. This association remained significant in the RRMS group (OR 10.1; 95% CI 1.3-67.8; p 0.031) when the model excluded PPMS and SPMS. According to our study, for every increase of 1 z score of FVC, we observed an increase of 0.25 cm3 of hippocampal volume (β 0.25; 95% CI 0.03-0.47; p 0.023) and 0.43 cm3 of left hippocampus volume (β 0.43; 95% CI 0.16-0.71; p 0.002). CONCLUSIONS We observed an incremental prevalence of abnormally low pulmonary function tests that parallels a sequence from more early relapsing courses to long-standing progressive courses (RRMS to PPMS or SPMS).
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Affiliation(s)
- Iván Murrieta-Álvarez
- Clínica Ruiz, Centro de Hematología y Medicina Interna, Puebla, México
- Universidad Popular Autónoma del Estado de Puebla, Puebla, México
- Baylor College of Medicine, Houston, TX, USA
| | - José A Fernández-Gutiérrez
- Clínica Ruiz, Centro de Hematología y Medicina Interna, Puebla, México
- Universidad Popular Autónoma del Estado de Puebla, Puebla, México
| | | | | | - Óscar A Reyes-Cisneros
- Clínica Ruiz, Centro de Hematología y Medicina Interna, Puebla, México
- Universidad Anáhuac Puebla, Tlaxcalancingo, México
| | - José M Benítez-Salazar
- Universidad Popular Autónoma del Estado de Puebla, Puebla, México
- Houston Methodist Hospital, Houston, TX, USA
| | - Daniela Sánchez-Bonilla
- Clínica Ruiz, Centro de Hematología y Medicina Interna, Puebla, México
- Universidad Popular Autónoma del Estado de Puebla, Puebla, México
| | | | | | | | - Guillermo J Ruiz-Delgado
- Clínica Ruiz, Centro de Hematología y Medicina Interna, Puebla, México
- Universidad Popular Autónoma del Estado de Puebla, Puebla, México
- Laboratorios Ruiz SYNLAB, Puebla, México
| | - Guillermo J Ruiz-Argüelles
- Clínica Ruiz, Centro de Hematología y Medicina Interna, Puebla, México.
- Universidad Popular Autónoma del Estado de Puebla, Puebla, México.
- Laboratorios Ruiz SYNLAB, Puebla, México.
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Enrichi C, Regazzetti M, Cieślik B, Zanetti C, D’Imperio D, Compagno E, Cacciante L, Federico S, Pregnolato G, Zitti M, Kiper P. How Lung Volume Recruitment Maneuvers Enhance Respiratory Function in Multiple Sclerosis Patients: A Quasi-Randomized Pilot Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1896. [PMID: 38003947 PMCID: PMC10672745 DOI: 10.3390/medicina59111896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/22/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: In patients with multiple sclerosis (MS), a decrease in muscle strength can lead to limitations in pulmonary functions, potentially causing respiratory complications. To address these challenges, the lung volume recruitment (LVR) maneuver has emerged as a potential intervention. This study sought to evaluate the impact of a four-week LVR protocol on respiratory function in secondary progressive MS patients. Materials and Methods: In a quasi-randomized pre/post-controlled trial, 24 patients with secondary progressive MS were recruited. Participants aged 20-70 years with an EDSS score of 2 to 9 were alternately allocated to intervention (n = 12) or control groups (n = 12). The intervention group underwent a 4-week respiratory rehabilitation training focused on LVR, using a standardized cough machine treatment protocol twice daily. The control group received no respiratory intervention. Outcomes measured included forced vital capacity (FVC), maximal insufflation capacity (MIC), and peak cough flow (PCF), using turbine spirometry and other associated equipment. All measurements were taken at baseline (T0) and after 4 weeks (T1) by a blinded assessor. Results: For the intervention group, the mean difference pre/post-treatment in MIC (mL) was 0.45 (SD 1.13) (p = 0.02), and in MIC (%), it was 0.13 (SD 0.24) (p = 0.03). Compared to the control group (n = 10), the between-group mean difference for MIC (mL) was 0.54 (p = 0.02), and for MIC (%), it was 0.15 (p = 0.02). Conclusions: The short-term daily LVR protocol notably improved passive lung capacity, despite minimal changes in active lung capacity or cough force. The LVR maneuver offers promise for enhancing respiratory function, especially passive lung capacity, in secondary progressive MS patients. Further research should explore optimal treatment durations and frequencies for more extensive respiratory gains.
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Affiliation(s)
- Claudia Enrichi
- Physical Medicine and Rehabilitation Unit, Azienda ULSS, 3 Serenissima, 30126 Venice, Italy; (C.E.)
| | - Martina Regazzetti
- Healthcare Innovation Technology Lab., IRCCS San Camillo Hospital, 30126 Venice, Italy
| | - Błażej Cieślik
- Healthcare Innovation Technology Lab., IRCCS San Camillo Hospital, 30126 Venice, Italy
| | - Cristiano Zanetti
- Physical Medicine and Rehabilitation Unit, Azienda ULSS, 3 Serenissima, 30126 Venice, Italy; (C.E.)
| | | | - Elisa Compagno
- CKR Centre de Kinésithérapie et Rééducation, 06000 Nice, France
| | - Luisa Cacciante
- Healthcare Innovation Technology Lab., IRCCS San Camillo Hospital, 30126 Venice, Italy
| | - Sara Federico
- Healthcare Innovation Technology Lab., IRCCS San Camillo Hospital, 30126 Venice, Italy
| | - Giorgia Pregnolato
- Healthcare Innovation Technology Lab., IRCCS San Camillo Hospital, 30126 Venice, Italy
| | - Mirko Zitti
- Healthcare Innovation Technology Lab., IRCCS San Camillo Hospital, 30126 Venice, Italy
| | - Pawel Kiper
- Healthcare Innovation Technology Lab., IRCCS San Camillo Hospital, 30126 Venice, Italy
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Ozen MS, Calik-Kutukcu E, Salci Y, Karanfil E, Tuncer A, Armutlu K. Is there a relationship between respiratory function and trunk control and functional mobility in patients with relapsing-remitting multiple sclerosis? Neurol Res 2023; 45:619-626. [PMID: 36780377 DOI: 10.1080/01616412.2023.2176628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
OBJECTIVE Multiple sclerosis (MS) causes impairment of respiratory function, trunk control, and functional mobility. The purpose of this study was to investigate the relationship between functional mobility and respiratory function and trunk control in MS patients and to compare the findings with those in healthy individuals. METHODS Thirty MS patients and 30 healthy subjects were included in this case-control study. All participants were evaluated with a pulmonary function test, maximal inspiratory and expiratory pressure (MIP, MEP), core stability tests, a lumbopelvic stability test (LST), a 2-minute walk test (2MWT), and the Timed Up and Go test (TUG). The disability level of the MS patients was assessed with the Expanded Disability Status Scale (EDSS). RESULTS Respiratory function, respiratory muscle strength, trunk control, and functional mobility were lower in the MS patients than in the controls (p < 0.05). TUG values had a significant negative correlation and the 2MWT values had a significant positive correlation with MEP, core stability tests, and the LST (p < 0.05). Of the variance in the 2MWT distance, 69% was explained by the LST, EDSS, and MEP; of the variance in TUG time, 40% was explained by the EDSS and MEP (p < 0.05). CONCLUSIONS To preserve and develop functional mobility in MS patients, approaches to increase respiratory function and trunk control should be included in rehabilitation programs. CLINICALTRIALS.GOV REGISTRATION NUMBER NCT03826095.
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Affiliation(s)
- Melike Sumeyye Ozen
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Bandirma Onyedi Eylul University, Bandirma, Turkey
| | - Ebru Calik-Kutukcu
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Yeliz Salci
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ecem Karanfil
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Asli Tuncer
- Faculty of Medicine, Department of Neurology, Hacettepe University, Ankara, Turkey
| | - Kadriye Armutlu
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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Charro PD, Santana LL, Seki KLM, Moro Junior N, Domingos JA, Christofoletti G. Motor and respiratory functions are main challenges to patients with multiple sclerosis. FISIOTERAPIA EM MOVIMENTO 2023. [DOI: 10.1590/fm.2023.36101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Abstract Introduction People with multiple sclerosis (MS) present wide and varied symptoms. Objective To investigate the impact of MS on subjects’ motor and respiratory functions. Methods One hundred one participants were enrolled in this study. The subjects had previous diagnosis of relapsing-remittent MS (n = 48) or presented no neurologic diseases (n = 53, control group). Assess-ments involved mobility (Timed Get Up and Go) and balance (Berg Balance Scale) tests. A force platform was used to evaluate postural stabilometry. Respiratory functions were assessed with a portable spirometer and a digital manovacuometer. Data analyses were carried out with Student´s t-tests, chi-square, and Pearson correlation index. Significance was set at 5%. Results Compared to control peers, participants with MS showed higher motor dysfunctions affecting mobility, balance, and postural stability. Spirometry indicated normal parameters for pulmonary flows and lung capacities in both groups. The manovacuometer, differently, pointed to a respiratory muscle weakness in 48% of participants with MS. Correlation analyses highlighted that respiratory functions are more associated to dynamic than to static motor tests. Conclusion Pathological changes in MS lead to motor dysfunction on mobility, balance and postural stability. Respiratory tests showed normal pulmonary flows and lung capacities in patients with MS, but with commitment of respiratory muscle strength. Respiratory functions were more impacted by dynamic tasks rather than static motor tasks.
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Sepehri Far S, Amiri B, Sahebozamani M, Ebrahimi HA. Improvement in the multiple sclerosis functional composite score by multi-function swing suspension training program. Mult Scler Relat Disord 2022; 67:104174. [PMID: 36174257 DOI: 10.1016/j.msard.2022.104174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 08/18/2022] [Accepted: 09/09/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Physical activity has been considered as a promising approach to slow down the disease process in Multiple Sclerosis (MS) patients. The functional impairments of MS have been studied in detail, while evidence of the efficacy of exercise training interventions on the Multiple Sclerosis functional composite (MSFC) score in these patients is limited. The aim of this study was to investigate the improvement in MSFC score by multi-function swing suspension training program (MFSST) in the women with MS. METHODS The patients were divided into two groups as the intervention and control groups. A total of 47 MS patients completed the MSFC components at baseline and after the intervention: the timed 25-foot walk (T25FW); the 9-hole peg test (9HPT); and paced auditory serial addition test (PASAT). Z scores were created for each test based on control means. RESULTS The MSFC score, 9HPT, T25FW, and PASAT showed a significant increment in comparison with the baseline levels in the four, six, and eight weeks following the first exercise session (all p<0.05). These differences in the control group were not significant. The improvement in the MSFC score and the component Z-scores in the intervention groups was found from the fourth week onwards. CONCLUSIONS The study findings highlight that the progression of MS disability can be partially compensated by physical exercise. Overall, these results indicate that MFSST can be used as an effective treatment method in patients suffering from MS. Longer (years) exercise studies with larger samples of MS patients, with different MS subtypes, and of different sex, are needed to evaluate the effect of other types of exercise interventions on the MSFC score in MS patients with different disabilities.
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Affiliation(s)
- Sara Sepehri Far
- Department of Sports Injuries and Corrective Exercises, Faculty of Physical Education and Sport, Kerman, Iran
| | - Banafsheh Amiri
- Department of Sports Injuries and Corrective Exercises, Faculty of Physical Education and Sport, Kerman, Iran; Department of Biological and Medical Sciences, Faculty of Physical Education and Sport, Comenius University in Bratislava, Slovakia.
| | - Mansour Sahebozamani
- Department of Sports Injuries and Corrective Exercises, Faculty of Physical Education and Sport, Kerman, Iran.
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Eshaghzadeh S, Abbaspour S, Sarboozi-hoseinabadi T, Eshaghzadeh M, Tatari M, Ramezani Nezhad M, Saravani H, Hamidi R, Aghabeigi A, Rahimi S, Sarmadi M. Quality of Life and Cognitive Emotion Regulation Strategies in Multiple Sclerosis Patients. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2022. [DOI: 10.1007/s10942-022-00474-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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8
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Huang MH, Doyle L, Burnham A, Fry DK, Shea K. Predictors of positive outcomes following resistive inspiratory muscle training in non-ambulatory persons with advanced multiple sclerosis. Mult Scler J Exp Transl Clin 2022; 8:20552173211058862. [PMID: 35634011 PMCID: PMC9134439 DOI: 10.1177/20552173211058862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 10/22/2021] [Indexed: 11/17/2022] Open
Abstract
Background Inspiratory muscle training (IMT) using a threshold device improves
inspiratory muscle strength. What factors influence the IMT outcome has not
been examined. Objective To identify predictors of the positive outcome following IMT in persons with
advanced multiple sclerosis (PwAMS). Methods Inclusion criteria were non-ambulatory PwAMS, Expanded Disability Status
Scale (EDSS) ≥6.5, age >18 years, no acute medical conditions, current
non-smokers, and ability to consent. Participants (n = 38)
performed daily inspiratory exercises using a resistive threshold device for
10 weeks. Baseline measurements included age, sex, body mass index, year
post multiple sclerosis diagnosis, comorbidities, EDSS, Modified Fatigue
Impact Scale-5, and oral Symbol Digit Modality Test. The percentage of
completed prescribed exercise trials (Trials%) during the 10-week
intervention was calculated. Age- and sex-adjusted predicted values of
maximum inspiratory pressure (MIP%pred) and maximum expiratory pressure
(MEP%pred) were obtained before and after the 10-week intervention. Backward
multivariable regression analyses for the primary outcome (MIP%pred) were
conducted. Results After controlling for the initial MIP%pred, perceived fatigue at the baseline
and Trial% were significant and independent predictors of MIP%pred after
IMT. Conclusion Less fatigue at the baseline and higher adherence to the prescribed exercise
repetitions were positive predictors of the positive outcome following IMT
in PwAMS.
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Affiliation(s)
- Min Hui Huang
- Physical Therapy Department, College of Health Sciences, University of Michigan-Flint, Flint, MI, USA
| | - Lisa Doyle
- Doctor of Physical Therapy Program, Franklin Pierce University, Manchester, NH, USA
| | | | - Donna K. Fry
- College of Health Sciences, University of Michigan-Flint, Flint, MI, USA
| | - Keelin Shea
- Doctor of Physical Therapy Program, Franklin Pierce University, Manchester, NH, USA
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Smyrke N, Dunn N, Murley C, Mason D. Standardized mortality ratios in multiple sclerosis: Systematic review with meta-analysis. Acta Neurol Scand 2022; 145:360-370. [PMID: 34820847 DOI: 10.1111/ane.13559] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To perform a meta-analysis of all-cause, cause-specific and gender-specific standardized mortality ratio and crude mortality rate for people with multiple sclerosis. We also examined the temporal trends in this data. METHODS Medline, Cochrane Library and Scopus were searched. Keywords were "multiple sclerosis" and "standardized mortality ratio" or "Standardized Mortality Ratio". We included longitudinal studies with available data on the number of deaths, follow-up period, person years and reports of standardized mortality ratio (SMR). Crude mortality ratio (CMR) was calculated and SMR was extracted. CMRs and log-SMR were pooled by the method of inverse variance. Meta-regression models were used to investigate temporal trends. RESULTS Fifty-seven articles were screened. Fifteen studies were included covering a period 1949-2013 (160,000 patients; 21,225 deaths). The all-cause SMR for people with MS was 2.61 (95% CI 2.58 to 2.65). For men this was 2.47 (95% CI 2.42 to 2.52) and for women 2.57 (95% CI 2.53 to 2.61). The CMR was 13.45/1000 person years. Cause-specific SMR was 1.74 (1.67 to 1.81) for CVD, 4.70 (4.45 to 4.87) for respiratory disease and infection, 1.81 (1.64 to 2.0) for accident and suicide and 0.99 (0.93 to 1.06) for cancer. Meta-regression analysis of the SMR compared to midpoint follow-up year revealed no relationship (co-efficient 0.001, p = .98). CONCLUSIONS People with multiple sclerosis (MS) have reduced overall survival and increased risk of death from cardiovascular, respiratory and infectious disease as well as accidents and suicide. This does not appear to have changed over the last 65 years.
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Affiliation(s)
- Natasha Smyrke
- School of Medicine and Surgery University of Auckland Auckland New Zealand
| | - Nicky Dunn
- Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden
- Center for Molecular Medicine Stockholm Sweden
| | - Chantelle Murley
- Division of Insurance Medicine Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden
| | - Deborah Mason
- Department of Neurology Christchurch Hospital Christchurch New Zealand
- New Zealand Brain Research Institute Christchurch New Zealand
- Department of Medicine University of Otago Christchurch New Zealand
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Eren F, Ozkan B, Demir A. The relationship between dysphagia, respiratory functions and anthropometry in patients with multiple sclerosis. Mult Scler Relat Disord 2021; 55:103192. [PMID: 34371272 DOI: 10.1016/j.msard.2021.103192] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/08/2021] [Accepted: 08/01/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND It is known that many body systems are affected as a result of dysphagia. The aim of this study is to investigate the relationship between clinical features, respiratory functions, anthropometric measurements and dysphagia in patients with multiple sclerosis (MS). METHOD Seventy-five MS patients and 50 healthy controls were included in this prospective case-control study. Disability was assessed with expanded disability status scale (EDSS), and swallowing was assessed with questionnaire for the assessment of dysphagia (solid, liquid and total) for disease. Respiratory functions were demonstrated with computerized spirometry device. Body weight, height, waist, hip, and mid-arm circumference are measured. Body mass index and body fat percentage were calculated. The relationship of all these parameters with disease activity and dysphagia was investigated. RESULTS There were 75 MS patients with a mean age of 38.40 ± 11.27 years, and 50 (66.70%) were female in the study. The all type of dysphagia scores were higher in MS patients than control group (p = 0.001). Many respiratory function test scores and only hip circumference were lower in MS patients. However, especially low forced expiratory volume-1st second (FEV1), forced vital capacity (FVC) and peak expiratory flow (PEF) values were associated with disability. In addition, dysphagia scores were higher in progressive MS patients with severe disability and high frequency attacks (p = 0.001). Increased severity of dysphagia are associated with many lower anthropometric measurements (not height-especially mid-arm circumference) and respiratory function test scores. CONCLUSION MS affects swallowing and respiratory systems functions. They are associated with MS disease activity. Dysphagia and its severity are associated with many anthropometric measurements and respiratory functions test scores.
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Affiliation(s)
- Fettah Eren
- Department of Neurology, Selcuk University Faculty of Medicine, Seven street & Number 1B, Konya 42700, Turkey.
| | - Bengu Ozkan
- Konya City Hospital, Chest Diseases Clinic, University of Health Sciences Turkey, Konya 42700, Turkey.
| | - Aysegul Demir
- Konya City Hospital, Neurology Clinic, University of Health Sciences Turkey, Konya 42700, Turkey.
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Is there a relationship between anxiety and depression with respiratory functions in patients with relapsing-remitting multiple sclerosis? Mult Scler Relat Disord 2021; 52:103023. [PMID: 34049218 DOI: 10.1016/j.msard.2021.103023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 04/24/2021] [Accepted: 05/07/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Psychiatric symptoms are common in multiple sclerosis. The relationship of emotional state with respiratory function is unclear in these patients. We aimed to evaluate the relationship between the clinical characteristics, anxiety and depression status, and respiratory functions of patients with relapsing-remitting multiple sclerosis (RRMS). METHOD The research was planned as a prospective case-control study. Ninety RRMS patients and 50 healthy controls were included in the study. The MS diagnosis was confirmed according to the revised 2017 McDonald's criteria. Disability was divided into two subgroups according to the Expanded Disability Status Scale (EDSS) (under 3.5 and 3.5-5.5). Beck anxiety and Beck depression inventories evaluated. A pulmonary function test was performed with a computerized spirometry device. Forced expiratory volume-1st second (FEV1), forced vital capacity (FVC), FEV/FVC, peak expiratory flow (PEF), maximal expiratory flow (MEF), peak inspiratory flow (PIF), and maximal inspiratory flow (MIF) values were obtained. RESULTS There were 90 RRMS patients with a mean age of 38.68±10.95 years, and 58 (64.40%) were female in the study. The anxiety and depression scores of the patients were significantly higher than the control group (p=0.02, 0.002). FVC and FEV1 values were lower in patients with higher Beck depression scores (p=0.012, 0.007). FVC, FEV1, MEF50, and PIF values were lower in patients with higher Beck anxiety scores (p=0.002, 0.002, 0.030, 0.027). When EDSS and number of attacks were fixed, there was a low to moderate correlation between anxiety and FEV1-FVC (p=0.001, r=-367, -0.360 respectively), and a low negative correlation between depression and FEV1 (p=0.045, r=-0.214). CONCLUSION Anxiety and depression scores are higher in patients with RRMS. Depression and anxiety are particularly associated with low FVC and FEV1 in patients.
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Knoble N, Nayroles G, Cheng C, Arnould B. Illustration of patient-reported outcome challenges and solutions in rare diseases: a systematic review in Cushing's syndrome. Orphanet J Rare Dis 2018; 13:228. [PMID: 30567582 PMCID: PMC6299940 DOI: 10.1186/s13023-018-0958-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 11/20/2018] [Indexed: 12/15/2022] Open
Abstract
Rare diseases are often not fully understood and efforts put in investigating it from patient perspective are usually met with challenges. We performed a systematic literature review (SLR) for the last 20 years in Cushing's Syndrome (CS) to illustrate Patient-Reported Outcome (PRO) challenges, and show what solutions were found.PROs and other Clinical Outcome Assessment (COA) used with CS patients were reviewed in 36 studies. Two CS-specific Health Related Quality of Life (HRQL) measures were identified (i.e., CushingQoL, Tuebingen CD-25), as well as depression and neurocognitive measures. For CS-specific HRQL measures, the CushingQoL was the most widely used measure due in part to being the first CS-specific HRQL measure developed. With algorithms mapping the CushingQoL to both the SF-6D and EQ-5D, the CushingQoL could be used to facilitate economic modelling studies in the absence of a generic HRQL measure. While the CushingQoL offers only the global scale and two subscales compared to the six subscales of the Tuebingen CD-25, there is not yet adequate statistical validation data available for the Tuebingen CD-25 to suggest it can withstand the scrutiny of review by multiple stakeholders. Results of this review indicate that the inclusion of a measure of depressive symptoms, such as the BDI-II or similar measure, would be reasonable to include given the high level of comorbidity of depression among CS patients. A brief neurocognitive performance outcome, such as Trail Making tasks A and D or Digit Symbol, could help inform the interpretation of HRQL results. Neurocognitive differences may be an unassessed mediator of HRQL outcomes, partly accounting for the persistence of depressive symptoms and HRQL deficits despite treatment. Results suggest that HRQL improvements are possible within this population. These results are limited by small sample sizes and pre/post study design.CS showcases the difficulties encountered in measuring PROs in rare diseases. A solution for this specific case was developed in the form of dedicated PRO instruments, the CushingQOL and the Tuebingen-25. However, some aspects of CS may not be fully answered or not yet validated (e.g., depressive and cognitive symptoms). Further research needs to be done to address them.
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Affiliation(s)
- Naomi Knoble
- Mapi, an ICON plc Company, 27 rue de la Villette, 69003 Lyon, France
| | | | - Cherry Cheng
- Ipsen Pharma, 65 quai Georges Gorse, 92560 Boulogne-Billancourt, France
| | - Benoit Arnould
- Mapi, an ICON plc Company, 27 rue de la Villette, 69003 Lyon, France
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