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Research Shows No Link Between Vaccinations, Risk for Multiple Sclerosis
October 21, 2014


TUESDAY, Oct. 21, 2014 (HealthDay News) -- A new study finds no link between vaccines and increased risk of multiple sclerosis or similar nervous system diseases.

Even though some have questioned whether vaccines -- particularly for hepatitis B and human papillomavirus (HPV) -- might be associated with a small rise in the risk of MS, prior studies yielded mixed findings on the issue, with most studies showing no link.

Many of those studies were limited by small numbers of participants and other factors, said the new team of researchers led by Dr. Annette Langer-Gould of Kaiser Permanente, Southern California, and colleagues.

In their new research, Langer-Gould's team analyzed data from 780 patients with MS or related diseases and compared their vaccination histories with that of more than 3,800 healthy patients. The participants included females aged 9 to 26, which is the indicated age range for HPV vaccination.

The researchers found no link between any vaccine -- including for hepatitis B and HPV -- and an increased risk of MS or related diseases for up to three years after vaccination, according to the study published online Oct. 20 in the journal JAMA Neurology.

Among patients younger than 50, there was an increased risk of the onset of MS and related diseases in the first 30 days after vaccination, but that association vanished after 30 days, the researchers found. That suggests that vaccination may accelerate the onset of symptoms in people who already have MS or related diseases but have not experienced any symptoms.

"Our data do not support a causal link between current vaccines and the risk of MS or [related diseases]. Our findings do not warrant any change in vaccine policy," the study authors wrote.

One expert in multiple sclerosis believes the study results are reassuring.

"While lingering questions about the safety of any vaccine continue to arise among the general public -- and especially among MS patients -- this well-executed study confirms what we already believe," said Dr. Karen Blitz, director of the North Shore-LIJ Multiple Sclerosis Center in East Meadow, N.Y.

"The general opinion [among experts] has always been that MS patients should receive flu shots, and now the data supports them receiving vaccinations for hepatitis B and HPV as well," she added.

"The only special consideration regarding vaccines that MS specialists recommend is that MS patients taking certain immunosuppressive drugs or disease-modifying therapies should stay away from vaccines containing 'live attenuated viruses,' such as the nasal mist vaccine for influenza," Blitz said.

More information

The American Academy of Family Physicians has more about multiple sclerosis.

Copyright © 2014 HealthDay. All rights reserved.

SOURCES: Karen Blitz, D.O., director, North Shore-LIJ Multiple Sclerosis Center, East Meadow, N.Y.; JAMA Neurology, news release, Oct. 20,...

Study: Undiagnosed Sleep Disorders Common With Multiple Sclerosis
September 12, 2014


FRIDAY, Sept. 12, 2014 (HealthDay News) -- The fatigue many people with multiple sclerosis (MS) experience may actually be a sign of an undiagnosed sleep disorder, according to a new study.

Researchers found that sleep disorders, which are more common among people with MS, are often left undiagnosed and untreated. Left untreated, sleep disorders could affect the progression of the disease, as well as affect people's overall well-being, the study authors cautioned.

"Sleep disorder frequency, sleep patterns and complaints of excessive daytime sleepiness suggest that sleep problems may be a hidden epidemic in the MS population, separate from MS fatigue," said Steven Brass, associate clinical professor and director of the Neurology Sleep Clinical Program and co-medical director of the UC Davis Sleep Medicine Laboratory in a university news release.

MS is an inflammatory disease affecting the white matter and spinal cord. Although the cause of MS is unclear, it is thought to be an autoimmune condition, according to the researchers. Symptoms include vision loss, vertigo, weakness and numbness. Fatigue is also a key symptom of MS.

The study, published online on Sept. 12 in the Journal of Clinical Sleep Medicine, involved almost 2,400 people diagnosed with MS. Most of the study participants were women, and most were white. The mean age was 54 years.

The participants were asked to complete a survey that included questions about their sleep history, daytime sleepiness, insomnia and restless legs syndrome. Nearly 52 percent of the participants needed more than 30 minutes to fall asleep at night. Almost 11 percent needed medication to help them fall asleep.

The researchers found that more than 70 percent of these patients had at least one sleep disorder. Nearly 38 percent of those surveyed were diagnosed with obstructive sleep apnea, almost 32 percent had moderate to severe insomnia and around 37 percent had restless legs syndrome.

However, most of the patients with a sleep disorder had not been diagnosed, the study revealed. In fact, only about 4 percent of those with obstructive sleep apnea had been diagnosed by a doctor.

"A large percentage of MS subjects in our study are sleep deprived and screened positive for one or more sleep disorders," said Brass. "The vast majority of these sleep disorders are potentially undiagnosed and untreated. This work suggests that patients with MS may have sleep disorders requiring independent diagnosis and management."

More information

The National Multiple Sclerosis Society provides more information on sleep disorders and MS.
Copyright © 2014 HealthDay. All rights reserved.

SOURCE: University of California - Davis Health System, news release, September 12, 2014...

People With HIV May Be at Lower Risk for Multiple Sclerosis
August 05, 2014


MONDAY, Aug. 4, 2014 (HealthDay News) -- People with HIV seem to have a much lower risk of developing multiple sclerosis (MS) than those who don't have the virus, a new study finds.

This lower risk may be due to constant suppression of the immune system due to the HIV infection itself and/or the antiretroviral drugs used to treat the infection, according to the researchers.

They said their findings could prove important in finding new ways to treat MS, a degenerative nervous system disease.

The hospital study observed more than 21,000 HIV patients and nearly 5.3 million people in England who were followed for seven years. During that time, just seven people were diagnosed with MS instead of the expected 18 people. That means people with HIV seemed to be about 60 percent less likely to develop MS compared to those who didn't have HIV.

The longer a person had HIV, the less likely they were to develop MS. Compared to people in the general population, the risk of MS was 75 percent lower among people who had tested positive for HIV more than a year ago. The risk of MS was 85 percent lower among those who had tested positive for HIV more than five years ago.

Although this study linked HIV infection to a lower risk of MS, it wasn't able to prove that the HIV infection or treatments for HIV were the cause of the reduced risk.

"If subsequent studies demonstrate there is a causal protective effect of HIV and/or its treatment, and if the magnitude of it proves to be similar, this would be the largest protective effect of any factor yet observed in relation to the development of MS," wrote the study's authors.

Findings from the study were published online Aug. 4 in the Journal of Neurology Neurosurgery & Psychiatry.

This study adds to evidence suggesting a link between HIV infection and treatment and MS, but further research is needed to confirm this connection, Mia van der Kop, an epidemiologist at the University of British Columbia in Canada, wrote in an accompanying editorial.

More information

The U.S. National Library of Medicine has more about multiple sclerosis.

SOURCE: Journal of Neurology Neurosurgery & Psychiatry, news release, Aug. 4, 2014...

Risk for MS Among Patients' Relatives Not As High As Thought
January 27, 2014


MONDAY, Jan. 27, 2014 (HealthDay News) -- A new study suggests that relatives of patients with multiple sclerosis aren't as likely to develop the disease as previously believed, even though the illness is thought to be caused mainly by genetics.

The researchers, at Sweden's Karolinska Institute, tracked almost everyone within the country who had been diagnosed with the disease since 1968 -- about 28,000 people. The researchers looked at whether their relatives developed the disease and then analyzed a group of people without multiple sclerosis (MS) and their relatives.

Siblings of people with MS were seven times more likely to develop MS than the general population; the risk for children of MS patients was five times higher. Grandchildren and nieces and nephews, however, faced no higher risk.

"The population registers in Sweden are reliable tools for finding relatives to MS patients and their possible MS diagnosis, instead of relying on the patients' memories," study first author Helga Westerlind, a doctoral student in the institute's department of clinical neuroscience, said in an institute news release.

"Our study is a good example of how one can quickly achieve more reliable results than the previous studies that were based on patient groups collected in hospitals throughout decades," Westerlind said.

The researchers have also studied twins and found that genetics do indeed play a major role in MS.

The study appears in the Jan. 17 issue of the journal Brain.

More information

For more about multiple sclerosis, try the U.S. National Library of Medicine.Copyright © 2014 HealthDay. All rights reserved.

SOURCE: Karolinska Institute, news release, Jan. 22, 2014...

Vitamin D May Slow Multiple Sclerosis, Study Suggests
January 20, 2014


MONDAY, Jan. 20, 2014 (HealthDay News) -- Vitamin D may slow the progression of multiple sclerosis (MS) and also reduce harmful brain activity, a new study suggests.

Correcting vitamin D deficiency early in the course of the disease is important, according to the report, published online Jan. 20 in JAMA Neurology.

But some experts say it's too soon to recommend giving vitamin D supplements to people with the central nervous system disorder.

"No one knows what the connection between MS and vitamin D is," said Nicholas LaRocca, vice president for health care delivery and policy research at the National Multiple Sclerosis Society. "What they suspect is that vitamin D has some effect on the immune system."

Also, what dose of the vitamin might be appropriate isn't clear, he said. "We don't know what a good level would be. There is no scientific consensus on a treatment protocol. We may get to that point eventually," LaRocca said.

However, the lead researcher of the study, Dr. Alberto Ascherio, a professor of epidemiology and nutrition at the Harvard School of Public Health, is convinced that vitamin D -- often called the "sunshine vitamin" -- can be a real benefit to MS patients.

"These findings, combined with previous evidence that vitamin D deficiency is a risk factor for MS, and [research on] the immunological effects of vitamin D strongly suggest that maintaining an adequate vitamin D status is important in the treatment of MS," he said.

In the study, vitamin D levels at the time of the first MS symptoms predicted the progression of the disease over the following five years, Ascherio said.

People with lower vitamin D levels -- below 50 nanomoles per liter (nmol/L) -- were more likely to develop new brain lesions and had a worse prognosis than those with higher levels, Ascherio said. "Individuals who present with symptoms suggesting MS should be screened for possible vitamin D deficiency, and this should be corrected by vitamin D supplementation," he said.

MS is a chronic, debilitating disease. In many cases, symptoms are mild, but sometimes people with MS become unable to walk, write or speak.

Dr. Emmanuelle Waubant, director of the Regional Pediatric MS Center at the University of California, San Francisco, is among those urging caution regarding vitamin D supplementation.

"Although these data are exciting, these are just studies of association," Waubant said. "We still need to do a randomized clinical trial of vitamin D supplementation to confirm that supplementation improved MS outcomes."

Another expert agreed.

"The results are exciting because they confirm our own prior work," said Dr. Ellen Mowry, an assistant professor of neurology at Johns Hopkins University School of Medicine in Baltimore.

However, she added that no study has yet established whether taking vitamin D supplements helps reduce new symptoms and disability from occurring in people with MS. "It's possible that the effects we have seen in this and the prior studies are actually due to something else, and not to vitamin D insufficiency," she said.

Also, even though vitamin D is sold over the counter, it doesn't necessarily mean it's safe to take a lot. "Like any medication, it may have negative effects of which we are not aware," Mowry added.

Vitamin D is also obtained from sunlight and through certain foods, such as fatty fish and fortified dairy products.

Mowry and Waubant are heading up a large clinical trial of vitamin D in MS patients. Similar trials are underway in Europe and Australia, Waubant noted.

"It is my belief that these trials will help answer the important question of whether it is safe and effective to recommend high-dose vitamin D supplementation to people with MS," Mowry said.

For the study, researchers measured vitamin D levels in 465 patients with signs of MS who took part in a trial designed to study interferon beta-1b treatment. For the next five years, patients underwent MRI scans so the researchers could track brain lesions associated with the disease.

During the first year of follow-up, increases of 50 nmol/L of vitamin D were associated with a 57 percent lower risk of developing new brain lesions, the study findings showed.

In addition, patients had a 57 percent lower risk of relapse, the researchers found. They also had a 25 percent lower yearly increase in T2 lesion size (these hallmarks of MS appear as bright spots on an MRI) and a 0.41 percent lower yearly loss in brain size over the course of the study.

More information

For more information on multiple sclerosis, visit the National Multiple Sclerosis Society.
Copyright © 2014 HealthDay. All rights reserved.

SOURCES: Alberto Ascherio, M.D., Dr.P.H., professor, epidemiology and nutrition, Harvard School of Public Health, Boston; Nicholas LaRocca, Ph.D., vice president, health care delivery and policy research, National Multiple Sclerosis Society, New York City...

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