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Sunshine ‘can help protect against MS’

New research shows exposure to sun in children and young people can help reduce their risk

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Exposure to sunshine for children and young adults may protect against multiple sclerosis (MS), new research has revealed. 

In questionnaires filled in by 332 participants with MS or their parents, 19 per cent stated that they spent less than 30 minutes daily outdoors during the previous summer, compared to six per cent of those who did not have MS. 

When the researchers adjusted for MS risks, like smoking and female sex, they found that the participants – aged between three and 22 – who spent an average of 30 minutes to one hour outdoors daily had a 52 per cent lower chance of MS, compared to those who spent an average of less than 30 minutes outdoors daily.

“Sun exposure is known to boost vitamin D levels,” said co-senior author Dr Emmanuelle Waubant, professor in the UCSF department of neurology and of the Weill Institute for Neurosciences. 

“It also stimulates immune cells in the skin that have a protective role in diseases such as MS. Vitamin D may also change the biological function of the immune cells and, as such, play a role in protecting against autoimmune diseases.

“Advising regular time in the sun of at least 30 minutes daily especially during summer, using sun protection as needed, especially for first degree relatives of MS patients, may be a worthwhile intervention to reduce the incidence of MS.”

The study follows previous work by other researchers that has demonstrated an association between increased ultraviolet exposure in childhood and lower odds of adult MS. The positive impact of sunshine has also been shown in a host of other conditions, including Long COVID.

While MS usually strikes adults between the ages of 20 to 50, statistics show that up to five per cent of the one million patients in the United States with the condition begin experiencing symptoms in childhood. 

Paediatric-onset MS is initially highly inflammatory, but takes longer than adults to advance, with symptoms of secondary progression, such as moderate to severe weakness, poor coordination and bowel and bladder control, occurring on average 28 years after disease onset, according to experts. 

However, these disability landmarks are reached approximately ten years earlier than in adult MS.

The researchers also found an association with the intensity of sunlight and estimated that residents of Florida would be 21 per cent less likely than residents of New York to have MS. 

They noted that sun exposure was “dose-dependent,” the longer the exposure the lower the risk. And even exposure in the first year of life seemed to protect against MS, they said.

Clinical trials are needed to determine if “increasing sun exposure or vitamin D supplementation can prevent the development of MS or alter disease course post-diagnosis,” said Professor Waubant, also director of the UCSF Regional Pediatric Multiple Sclerosis Center.

MS

Could childhood trauma lead to MS in women?

The links were strongest with sexual abuse and for those who experienced several forms of abuse

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Childhood trauma may be linked to a heightened risk of multiple sclerosis (MS) in later life among women, new research has found. 

The associations were strongest for sexual abuse and for experience of several forms of abuse, the findings show.

The evidence suggests that childhood trauma can alter the immune system and may increase the risk of autoimmune disease. 

Abuse, neglect, and a chaotic home life are also associated with a heightened risk of poor mental and physical health in adulthood. 

In this study, researchers drew on participants in the nationally-representative Norwegian mother, father and child cohort study.

Nearly 78,000 pregnant women joined the study between 1999 and 2008, and their health was monitored until the end of 2018.

Information on childhood abuse before the age of 18 was gathered through questionnaire responses, while confirmation of MS diagnoses was obtained from linked national health registry data and hospital records.

In all, 14,477 women said they had experienced childhood abuse while 63,520 said they hadn’t. 

The women with a history of abuse were more likely to be current or former smokers – a known risk factor for MS – to be overweight, and to have depressive symptoms.

Some 300 women were diagnosed with MS during the monitoring period, nearly 1 in 4 of whom said they had been abused as children compared with around 1 in 5 of those who didn’t develop MS. 

After accounting for potentially influential factors, including smoking, obesity, educational attainment, and household income, the team concluded that women who had been abused as children were more likely to be diagnosed with MS.

The observed association was strongest for sexual abuse (65 per cent heightened risk), followed by emotional abuse (40 per cent heightened risk), and physical abuse (31 per cent heightened risk).

The risk was further increased for exposure to two categories of abuse (66 per cent heightened risk), rising to 93 per cent for exposure to all three categories, indicating a ‘dose-response’ association, suggest the researchers.

Similar results were obtained after the researchers excluded women who might have been in the early (prodromal) phase of MS when obvious symptoms had yet to appear.

And the association also persisted when women who had already been diagnosed with MS at the start of the study were included.

“Better understanding of the risk factors and timing of risk exposures, may open doors for prevention and give further insight to disease mechanisms,” the researchers conclude.

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MS

Pandemic ‘raised depression and anxiety’ for people with MS

Loneliness was also a key factor affecting mental health of people with MS during lockdown, research shows

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Depression, anxiety and loneliness all increased significantly during the COVID-19 pandemic among people living with multiple sclerosis (MS), a new study has revealed. 

MS researchers at Kessler Foundation compared pre-pandemic and pandemic data on emotional distress in 142 individuals with MS. 

The study revealed 54 per cent reporting ‘new’ depression, and 33 per cent ‘new’ anxiety. 

Increases in loneliness affected all people with depression and anxiety, whether symptoms were new or pre-existing.

The findings raise new concerns for treating mental health issues among people with MS, the research team said, adding to the already-known impact of social restrictions of the COVID-19 pandemic among the general population. 

Dr Lauren Strober

“We found that ‘new’ depression and anxiety appeared to be related specifically to the pandemic,” reported lead author Dr Lauren Strober, senior research scientist in the Center for Neuropsychology and Neuroscience at Kessler Foundation. 

“Also, we saw no association with the person-specific factors commonly associated with depression and anxiety in individuals with MS, namely, personality and self-efficacy.”

The MS research comes shortly after the “catastrophic” impact of lockdown on people living with Parkinson’s was revealed, with exacerbation of symptoms being a common occurrence. 

The findings of this study have important implications for the treatment of mental health issues in MS, the Kessler Foundation team said. 

The restrictions of the pandemic have been shown to lead to greater levels of loneliness in vulnerable communities, and must be addressed, said the team. 

“Clinicians need to be aware of the heterogenous nature of depression and anxiety in their patients with MS, and approach treatment accordingly,” said Dr Strober. 

“Individuals with new symptomatology will benefit from cognitive behavioral interventions that stress coping, positive mental health habits, and encouragement to connect with others despite the pandemic, while individuals with pre-existing symptoms may respond to those aimed at improving self-efficacy and other more fundamental factors of emotional distress.”

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Tech

App for MS patients tested at UK university

Roche is testing its Floodlight MS app in the University of Essex Brain Research and Imaging Centre

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A global pharmaceutical company is working with a UK university to test a new app to help people with multiple sclerosis (MS) better manage their symptoms. 

Roche has developed an app called Floodlight MS, with five activities collecting data on hand function, walking ability, and cognition – areas commonly affected in people living with MS.

Floodlight MS is a science-based smartphone app that enables people living with MS to objectively assess their physical and cognitive function in between medical appointments.

The app creates for clinicians a record of data to inform future conversations and enrich clinical decisions.

Roche has a longstanding relationship with Professor Jeremy Hobart and the MS research group at the University of Plymouth to co-design projects that help improve the quality of life for people with MS. 

Identifying a collaboration that could help move the new app forward, Professor Hobart made an introduction to the Motor Control Lab in the University’s new Brain Research and Imaging Centre (BRIC).

The lab, led by Professor in Rehabilitation, Jon Marsden, contains world-leading technology that will enable Roche to test and validate the app’s accuracy, while continually feeding the results into product development.

The work will see participants use Floodlight MS on provided mobile phones, with researchers independently exploring if the measures recorded by the device are comparable to the measures of movement quality recorded in the lab itself, therefore ensuring that the app is working as intended.

Licinio Craveiro, principal global medical director for Roche, said: “Roche’s mission is to ‘do now what patients need next’, so we’re looking to design, build and test solutions to help people overcome some of the world’s biggest health challenges.

“To do this, we need state-of-the-art technology and science at our fingertips, so we were delighted to be introduced to Professor Marsden and his team at the Brain Research and Imaging Centre. 

“We’re really looking forward to testing and moving Floodlight MS forward to help people with MS to manage their condition.”

Professor Marsden said: “BRIC contains world-leading technology to understand human movement, behaviour and neurological conditions, and the Motor Control Lab is all about understanding how we control movement and functional ability and how it is affected by pathology.

“We were pleased to collaborate with Roche on an innovative project to validate the Floodlight MS app and, as with everything we do in research, we look forward to seeing the product help people who need it most.”

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