MS Awareness Week

This week is MS AWARENESS WEEK!  Plus, all of March is MS Awareness Month, so spread the word - the more people know, the more likely we can work together to find a cure.

Here is more from my MSF email:

Research Investigates MS Lesion Impact on Brain and Behavior
Researchers at Wayne State University are taking a closer look at MS damage in the brain to better understand how lesions create certain symptoms, including cognitive, emotional, and behavioral changes. Their hope is that one day this information can be used to develop treatments that can be used to alleviate these symptoms more effectively than those being used today.
Treating MS patients with drugs used for typical behavioral disorders such as schizophrenia and depression can have terrible side effects and can be ineffective because the drugs are attempting to rectify nonexistent imbalances in brain neurochemicals, according to Alexander Gow, Ph.D., professor in Wayne State University's Center for Molecular Medicine and Genetics and School of Medicine's departments of pediatrics and neurology.
While not everyone with MS has cognitive problems, over time some people can lose their ability to focus mentally, forget what they want to do, or have difficulty following conversations. They also can become extremely depressed or frustrated at their inability to perform daily mental functions.
Gow believes the immune system attacks that damage or destroy white matter brain cells (oligodendrocytes) and cause the more catastrophic symptoms of MS also destroy cells in the brain's gray matter cells (neurons), where auditory, visual and cognitive functions are based.
"Changes in gray matter could well be associated with emotional outbursts," Gow said. "Cells involved in memory and learning are also being destroyed. Whenever those sorts of changes occur, you almost always see frustration in patients as they try to grapple with the resultant loss in mental capacity.
"That causes them to be upset about not being able to do things, even if they don't know that's what's going on physically. This can also lead to them withdrawing from social settings with family and friends, which deepens the impact of MS."
MS patients' more severe symptoms result when the immune system attacks the myelin that surrounds white matter cells, causing lesions that are visible in magnetic resonance imaging scans. Gow said if viewed the right way, lesions also can be seen in gray matter, indicating that neurons and not just oligodendrocytes are being destroyed.
"That then gives us an anatomical basis for memory loss and patients' inability to focus," Gow said.
Researchers will examine white matter for specific changes indicating the presence of biomarker substances that cause MS-like symptoms. If those substances are found, researchers then can try to administer drugs to reverse the effects of the myelin attacks.
"Using different classes of existing drugs," Gow said, "novel therapies can be developed with shorter delays in moving from the bench to the bedside."

High Resolution Images Reveal Receptor Action Key to MS
A team of scientists from The Scripps Research Institute, collaborating with members of the drug discovery company Receptos, created the first high-resolution virtual image of cellular structures known as S1P1 receptors, which are critical in controlling the onset and progression of MS and other diseases.
The new study used the technique of x-ray crystallography to reveal the high-resolution 3D image of the S1P1 receptor. The results provide scientists with new details about the receptor’s mechanism of action.
One aspect of the receptor structure that is of particular interest is the binding pocket for the natural ligand or potential drugs that activate the receptor responses. The structure revealed how the binding pocket shifts to activate signaling. Understanding how that occurs makes it easier to identify additional compounds that might have effects in controlling the receptors.
With the structural information in hand, the scientists say they can advance efforts to understand the specific chemical transformations that drive the cellular responses tied to MS and other diseases.
Researchers have long known that S1P1 receptors play critical roles in controlling multiple sclerosis and other diseases. One way the receptors do this is by regulating the flow of certain white blood cells, or lymphocytes, out of lymph nodes.
This is critical because in patients with multiple sclerosis, auto-reactive lymphocytes attack the protective sheaths of nerve cells in the brain, causing malfunctions in the way the central nervous system transmits signals through the body. The S1P1 receptors are also involved in the progression of harmful scarring and swelling in response to lymphocyte damages in the brain.
The research was reported in the journal Science.

Implanted Microchip Delivers Injections on Demand
The first successful test has been reported for a programmable, wirelessly-controlled microchip that delivers drugs after being implanted in a patient’s body. Though the microchip in this study was administering daily doses of an osteoporosis drug normally given by injection, researchers project that the technology may one day also be applied to treatments for diseases such as MS.
In the new study, funded and overseen by MicroCHIPS, scientists used the programmable implants to deliver an osteoporosis drug called teriparatide to seven women aged 65 to 70. The study found that the device delivered dosages comparable to injections, and there were no adverse side effects.
The drug-delivering microchip is the brainchild of MIT professors Robert Langer and Michael Cima. The results of their study, published in the online edition of Science Translational Medicine, could help usher in a new era of telemedicine – delivering health care over a distance, Langer says.
"You could literally have a pharmacy on a chip," says Langer, the David H. Koch Institute Professor at MIT. "You can do remote control delivery, you can do pulsatile drug delivery, and you can deliver multiple drugs."
"Patients with chronic diseases, regular pain-management needs or other conditions that require frequent or daily injections could benefit from this technology," says Robert Farra, president and chief operating officer at MicroCHIPS and lead author of the paper.
"Compliance is very important in a lot of drug regimens, and it can be very difficult to get patients to accept a drug regimen where they have to give themselves injections," says Cima, the David H. Koch Professor of Engineering at MIT. "This avoids the compliance issue completely, and points to a future where you have fully automated drug regimens."
Once a version of the implant that can carry a larger number of doses is ready, MicroCHIPS plans to seek approval for further clinical trials, Farra says.

Brain Exercises Help Improve Cognition Skills
Functional magnetic resonance imaging (fMRI) shows that cognitive rehabilitation changes brain function and improves cognitive performance in people with relapsing-remitting MS, according to a new study from Italy.
"These results prompt the use of specific computer-based rehabilitation programs to treat deficits in selected neuropsychological domains in patients with relapsing-remitting MS," said the study's lead author, Massimo Filippi, M.D., professor of neurology at the San Raffaele Vita-Salute University and director of the "BrainMap" interdepartmental research program and the Neuroimaging Research Unit, Department of Neuroscience, Scientific Institute San Raffaele, Milan, Italy. "They also suggest that fMRI might provide useful metrics to monitor the effects of rehab in MS."
For the study, Dr. Filippi and colleagues recruited 20 patients with relapsing-remitting MS. Patients were randomized into two groups of 10. The first group received a 12-week program of computer-assisted cognitive rehabilitation of attention and information processing and executive functions, and the second (control) group received no cognitive rehabilitation.
Aspects of the rehabilitation program included a day-planning task, which employed realistic simulations of a set of scheduled dates and duties to address the patient's ability to organize, plan and develop solution strategies; and an attention task requiring the patient to simulate driving a train, carefully observing the control panel of the train and the countryside while encountering several distractions at increasing levels of difficulty.
All of the patients underwent neuropsychological assessment and MRI exams at baseline and after 12 weeks. As compared to their performance at baseline, the patients in the treatment group improved in tests of attention and information processing and executive functions. The fMRI results showed modifications in activity in several brain regions in the rehabilitation group, compared to the non-rehabilitation group. These fMRI modifications were correlated with cognitive improvement.
Analysis after cognitive rehabilitation found no structural changes in the gray matter or normal-appearing white matter of the brain in the treatment group.
"The findings demonstrated that computer-assisted cognitive rehabilitation in patients with MS results in an improvement of the trained cognitive functions," Dr. Filippi said. "However, the structural integrity of the brain's gray matter and white matter showed no modifications in these patients, suggesting an impairment of structural plasticity."

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