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Ivashynka A, Leone MA, Barizzone N, Cucovici A, Cantello R, Vecchio D, Zuccalà M, Pizzino A, Copetti M, D'Alfonso S, Fontana A. The impact of lifetime coffee and tea loads on Multiple Sclerosis severity. Clin Nutr ESPEN 2022; 47:199-205. [DOI: 10.1016/j.clnesp.2021.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 12/02/2021] [Accepted: 12/17/2021] [Indexed: 10/19/2022]
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Vanotti S, Caceres FJ. Cognitive and neuropsychiatric disorders among MS patients from Latin America. Mult Scler J Exp Transl Clin 2017; 3:2055217317717508. [PMID: 28979791 PMCID: PMC5617097 DOI: 10.1177/2055217317717508] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 06/04/2017] [Indexed: 11/20/2022] Open
Abstract
Cognitive and neuropsychiatric disorders in patients with multiple sclerosis have been extensively documented. The focus of this review will be on cognitive and neuropsychiatric disorders in multiple sclerosis patients from Latin America, in the context of international literature. Multicentre studies carried out in Latin America have shown that 43% of the patients have cognitive impairment and 34.5% in early stages of the disease, 29% depression and 20.9% neuropsychiatric disorders. The profile of cognitive impairment corresponds to alterations in visual and verbal memory, in attention, in information processing speed and in verbal fluency. The neuropsychiatric profile showed disorders in anxiety, depression, apathy and irritability domains. In the region, there exist validations of the multiple sclerosis neuropsychological screening questionnaire (MSNQ), the brief repeatable battery of neuropsychological tests (BRB-N) and the brief international cognitive assessment for multiple sclerosis (BICAMS), as well as of the paced auditory serial addition test (PASAT) and the symbol digit modalities test (SDMT). A study showed that 53% of the patients who met the NEDA3 condition had cognitive impairment. This finding highlights the need for taking cognitive assessment into account when determining therapeutic efficacy.
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Affiliation(s)
| | - Fernando J Caceres
- Multiple Sclerosis Clinic, INEBA - Neurosciences Institute of Buenos Aires, Argentina
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Reilly GD, Mahkawnghta AS, Jelinek PL, De Livera AM, Weiland TJ, Brown CR, Taylor KL, Neate SL, Jelinek GA, Marck CH. International Differences in Multiple Sclerosis Health Outcomes and Associated Factors in a Cross-sectional Survey. Front Neurol 2017; 8:229. [PMID: 28620343 PMCID: PMC5450014 DOI: 10.3389/fneur.2017.00229] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 05/11/2017] [Indexed: 11/13/2022] Open
Abstract
Multiple sclerosis (MS) is a major cause of disability and poor quality of life (QOL). Previous studies have shown differences in MS health outcomes between countries. This study aimed to examine the associations between international regions and health outcomes in people with MS. Self-reported data were taken from the Health Outcomes and Lifestyle In a Sample of people with Multiple Sclerosis online survey collected in 2012. The 2,401 participants from 37 countries were categorized into three regions: Australasia, Europe, and North America. Differences were observed between regions in disability, physical and mental health QOL, fatigue, and depression, but most of these disappeared after adjusting for sociodemographic, disease, and lifestyle factors in multivariable regression models. However, adjusted odds for disability were higher in Europe [odds ratio (OR): 2.17, 95% confidence interval (CI): 1.28 to 3.67] and North America (OR: 1.79, 95% CI: 1.28 to 2.51) compared to Australasia. There may be other unmeasured factors that vary between regions, including differences in access and quality of healthcare services, determining disability in MS. When assessing differences in MS health outcomes, lifestyle factors and medication use should be taken into consideration.
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Affiliation(s)
- Grace D Reilly
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Awng Shar Mahkawnghta
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Pia L Jelinek
- Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Alysha M De Livera
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,Biostatistics Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Tracey J Weiland
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Chelsea R Brown
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Keryn L Taylor
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Sandra L Neate
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - George A Jelinek
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Claudia H Marck
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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Weiland TJ, Jelinek GA, Marck CH, Hadgkiss EJ, van der Meer DM, Pereira NG, Taylor KL. Clinically significant fatigue: prevalence and associated factors in an international sample of adults with multiple sclerosis recruited via the internet. PLoS One 2015; 10:e0115541. [PMID: 25692993 PMCID: PMC4333355 DOI: 10.1371/journal.pone.0115541] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 11/25/2014] [Indexed: 11/18/2022] Open
Abstract
Background Fatigue contributes a significant burden of disease for people with multiple sclerosis (PwMS). Modifiable lifestyle factors have been recognized as having a role in a range of morbidity outcomes in PwMS. There is significant potential to prevent and treat fatigue in PwMS by addressing modifiable risk factors. Objectives To explore the associations between clinically significant fatigue and demographic factors, clinical factors (health-related quality of life, disability and relapse rate) and modifiable lifestyle, disease-modifying drugs (DMD) and supplement use in a large international sample of PwMS. Methods PwMS were recruited to the study via Web 2.0 platforms and completed a comprehensive survey measuring demographic, lifestyle and clinical characteristics, including health-related quality of life, disability, and relapse rate. Results Of 2469 participants with confirmed MS, 2138 (86.6%) completed a validated measure of clinically significant fatigue, the Fatigue Severity Scale. Participants were predominantly female from English speaking countries, with relatively high levels of education, and due to recruitment methods may have been highly pro-active about engaging in lifestyle management and self-help. Approximately two thirds of our sample (1402/2138; 65.6% (95% CI 63.7–67.7)) screened positive for clinically significant fatigue. Bivariate associations were present between clinically significant fatigue and several demographic, clinical, lifestyle, and medication variables. After controlling for level of disability and a range of stable socio-demographic variables, we found increased odds of fatigue associated with obesity, DMD use, poor diet, and reduced odds of fatigue with exercise, fish consumption, moderate alcohol use, and supplementation with vitamin D and flaxseed oil. Conclusion This study supports strong and significant associations between clinically significant fatigue and modifiable lifestyle factors. Longitudinal follow-up of this sample may help clarify the contribution of reverse causation to our findings. Further research is required to explore these associations including randomized controlled trials of lifestyle interventions that may alleviate fatigue.
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Affiliation(s)
- Tracey J. Weiland
- Emergency Practice Innovation Centre, St Vincent’s Hospital, Melbourne, Victoria, Australia
- Department of Medicine, The University of Melbourne (St Vincent’s Hospital), Melbourne, Victoria, Australia
- * E-mail:
| | - George A. Jelinek
- Emergency Practice Innovation Centre, St Vincent’s Hospital, Melbourne, Victoria, Australia
- Department of Medicine, The University of Melbourne (St Vincent’s Hospital), Melbourne, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Claudia H. Marck
- Emergency Practice Innovation Centre, St Vincent’s Hospital, Melbourne, Victoria, Australia
| | - Emily J. Hadgkiss
- Emergency Practice Innovation Centre, St Vincent’s Hospital, Melbourne, Victoria, Australia
| | - Dania M. van der Meer
- Emergency Practice Innovation Centre, St Vincent’s Hospital, Melbourne, Victoria, Australia
| | - Naresh G. Pereira
- Faculty of Medicine, Notre Dame University, Fremantle, Western Australia, Australia
| | - Keryn L. Taylor
- Department of Medicine, The University of Melbourne (St Vincent’s Hospital), Melbourne, Victoria, Australia
- Department of Psychiatry, St Vincent’s Hospital Melbourne, Victoria, Australia
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Hadgkiss EJ, Jelinek GA, Weiland TJ, Pereira NG, Marck CH, van der Meer DM. The association of diet with quality of life, disability, and relapse rate in an international sample of people with multiple sclerosis. Nutr Neurosci 2014; 18:125-36. [PMID: 24628020 PMCID: PMC4485697 DOI: 10.1179/1476830514y.0000000117] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Objectives To explore the association between dietary factors including fat, fruit and vegetable intake, dairy and meat consumption, and health-related quality of life (HRQOL), disability and relapse rate in a large international sample of people with multiple sclerosis (MS). Methods Participants with MS were recruited to the study via Web 2.0 platforms and completed a comprehensive survey measuring demographic and clinical characteristics, HRQOL, disability, relapse rate, and the Diet Habits Questionnaire (DHQ). Results Of 2469 participants with confirmed MS, 2087 (84.5%) provided complete data on their dietary habits (DHQ total score). Multivariate regression models demonstrated that every 10-point increase on the DHQ total score was associated with nearly a six-point and five-point increase in physical and mental HRQOL, respectively, and 30.0% reduced likelihood of a higher level of disability. After controlling for age and gender, and the other dietary covariates, ‘healthy’ consumption of fruit and vegetables and dietary fat predicted better quality of life and less likelihood of higher disability when compared to respondents with a ‘poor’ diet. For those with relapsing–remitting MS, the DHQ total significantly predicted a lower relapse rate and reduced odds of increasing disease activity, but the model fit was poor and the predicted change only marginal. Discussion This study supports significant associations of healthy dietary habits with better physical and mental HRQOL and a lower level of disability. Further research is urgently required to explore these associations including randomized controlled trials of dietary modification for people with MS.
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Affiliation(s)
- Emily J Hadgkiss
- Emergency Practice Innovation Centre, St Vincent's Hospital Melbourne, Victoria, Australia
- Correspondence to: Emily Hadgkiss, Emergency Practice Innovation Centre, St Vincents Hospital, PO Box 2900, Fitzroy, Melbourne, VIC 3065, Australia.
| | | | | | - Naresh G Pereira
- Faculty of Medicine, Notre Dame University, Fremantle, Western Australia, Australia
| | - Claudia H Marck
- Emergency Practice Innovation Centre, St Vincent's Hospital Melbourne, Victoria, Australia
| | - Dania M van der Meer
- Emergency Practice Innovation Centre, St Vincent's Hospital Melbourne, Victoria, Australia
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Methodology of an International Study of People with Multiple Sclerosis Recruited through Web 2.0 Platforms: Demographics, Lifestyle, and Disease Characteristics. Neurol Res Int 2013; 2013:580596. [PMID: 23691313 PMCID: PMC3649686 DOI: 10.1155/2013/580596] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 02/27/2013] [Accepted: 03/20/2013] [Indexed: 11/21/2022] Open
Abstract
Background. Despite evidence of the potential importance of the role of health and lifestyle behaviours in multiple sclerosis (MS) outcomes, there has not been a significant focus on this area of research. Aim. We aimed to recruit an international sample of people with MS at baseline and over a five-year timeframe, examine their health and lifestyle behaviours, and determine the relationship of these behaviours to self-reported disability, disease activity, and quality of life. Methods. People with MS were recruited through web 2.0 platforms including interactive websites, social media, blogs, and forums and completed a comprehensive, multifaceted online questionnaire incorporating validated and researcher-derived tools. Results. 2519 participants met inclusion criteria for this study. This paper describes the study methodology in detail and provides an overview of baseline participant demographics, clinical characteristics, summary outcome variables, and health and lifestyle behaviours. The sample described is unique due to the nature of recruitment through online media and due to the engagement of the group, which appears to be well informed and proactive in lifestyle modification. Conclusion. This sample provides a sound platform to undertake novel exploratory analyses of the association between a variety of lifestyle factors and MS outcomes.
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Fungal infection in cerebrospinal fluid from some patients with multiple sclerosis. Eur J Clin Microbiol Infect Dis 2013; 32:795-801. [PMID: 23322279 DOI: 10.1007/s10096-012-1810-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 12/18/2012] [Indexed: 01/19/2023]
Abstract
Multiple sclerosis (MS) is the prototypical inflammatory disease of the central nervous system and spinal cord, leading to axonal demyelination of neurons. Recently, we have found a correlation between fungal infection and MS in peripheral blood of patients. The present work provides evidence of fungal infection in the cerebrospinal fluid (CSF) of some MS patients. Thus, fungal antigens can be demonstrated in CSF, as well as antibodies reacting against several Candida species. Comparison was made between CSF and blood serum for the presence of fungal antigens (proteins) and antibodies against different Candida spp. Analyses of both CSF and serum are complementary and serve to better evaluate for the presence of disseminated fungal infection. In addition, PCR analyses indicate the presence of DNA from different fungal species in CSF, depending on the patient analyzed. Overall, these findings support the notion that fungal infection can be demonstrated in CSF from some MS patients. This may constitute a risk factor in this disease and could also help in understanding the pathogenesis of MS.
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