Major MS cognitive rehabilitation trial funded by NHS(21/11/14)
The Cognitive Rehabilitation for Attention and Memory trial (CRAMMS), a major study to be conducted on patients with multiple sclerosis, was recently awarded £1,167,000 by the National Health Service (NHS), through its Health Technology Assessment (HTA) Program.
The study, which is expected to be the largest trial of its kind in the United Kingdom, is designed to examine MS patients’ cognitive rehabilitation capacities and determine if a group of cognitive rehabilitation programs is able to improve patients’ quality of life.
This symptom management clinical trial for MS is being conducted because so many patients experience difficulties in cognitive processes, including loss in memory, decision making, and concentration, and there are currently few effective treatments available for the management of these symptoms. Therefore, the CRAMMS trial is expected to be able to advance the development of new therapies to improve the lives of patients with these problems.
The trial, which is expected to occur between September of 2014 and August of 2018 at four centres in Nottingham, Sheffield, Liverpool, and Birmingham, is currently enrolling patients, who must be diagnosed with MS and between the ages of 18 and 70 years old. During the trial, participants will be enrolled over the course of 16 months and will participate in either weekly group cognitive rehabilitation sessions with a psychologist and their usual care, or just their usual care. The investigators will then evaluate and compare the effects on the two groups.
“We do not know whether taking part in the study will help but we expect that some people will find the intervention helps them cope with memory and attention problems,” the website of the trial states. “However, the information we get from this study may help us to treat people with MS and attention and memory problems better in future. There are no particular risks involved in taking part in this study.”
In addition, the trial is also expected to raise particular attention and investment into other research focused to the disease.
Source: Multiple Sclerosis News Today © Copyright 2014 BioNews Services, LLC (21/11/14)
The study, which is expected to be the largest trial of its kind in the United Kingdom, is designed to examine MS patients’ cognitive rehabilitation capacities and determine if a group of cognitive rehabilitation programs is able to improve patients’ quality of life.
This symptom management clinical trial for MS is being conducted because so many patients experience difficulties in cognitive processes, including loss in memory, decision making, and concentration, and there are currently few effective treatments available for the management of these symptoms. Therefore, the CRAMMS trial is expected to be able to advance the development of new therapies to improve the lives of patients with these problems.
The trial, which is expected to occur between September of 2014 and August of 2018 at four centres in Nottingham, Sheffield, Liverpool, and Birmingham, is currently enrolling patients, who must be diagnosed with MS and between the ages of 18 and 70 years old. During the trial, participants will be enrolled over the course of 16 months and will participate in either weekly group cognitive rehabilitation sessions with a psychologist and their usual care, or just their usual care. The investigators will then evaluate and compare the effects on the two groups.
“We do not know whether taking part in the study will help but we expect that some people will find the intervention helps them cope with memory and attention problems,” the website of the trial states. “However, the information we get from this study may help us to treat people with MS and attention and memory problems better in future. There are no particular risks involved in taking part in this study.”
In addition, the trial is also expected to raise particular attention and investment into other research focused to the disease.
Source: Multiple Sclerosis News Today © Copyright 2014 BioNews Services, LLC (21/11/14)
A new mouse model for Multiple Sclerosis fatigue?(21/11/14)
Researchers presented a new mouse model for fatigue at the 2014 Society for Neuroscience meeting. The model is the first of its kind and works by manipulating the pro-inflammatory cytokine interleukin-1β.
There’s a new animal model coming down the pike that may be of use to multiple sclerosis researchers. At the Society for Neuroscience (SfN) annual meeting in Washington, D.C., researchers announced that they have developed a new mouse model for fatigue. This is the first mouse model to isolate fatigue from other symptoms.
Fatigue is said to be the most common and debilitating symptom of multiple sclerosis. It’s characterised less as sleepiness and more as an inability to function normally, even if the motivation is there.
“Surprisingly, this is an underrepresented area of research,” Mary Harrington, Ph.D., of Smith College said at an SfN press conference. “There is little to no understanding of what is the underlying neurobiology of fatigue.”
The model
The researchers began by activating the pro-inflammatory cytokine interleukin-1β (IL-1β) in young, middle-aged, and aged female mice. The animals demonstrated signs of fatigue, without any other signs of sickness (Bonsall et al, 2014). Middle-aged (6 to 12 months old) and aged mice (18 to 24 months old) almost completely stopped voluntary wheel-running compared to their baseline activity. They did not, however, show signs of fever, muscle ache, or anhedonia (decreased pleasure-seeking activity). The researchers saw no significant change in the young (3- to 5-month-old) mice.
The researchers also found that the treatment did not seem to act upon the neurotransmitter orexin to induce fatigue. Orexin is thought to mediate arousal and wakefulness. Unsurprisingly, the mice also did not respond well to medications that work on the arousal system, such as modafinil (Provigil, Teva Pharmaceuticals) or methylphenidate (Ritalin, Concerta, and others), a drug commonly prescribed to treat attention deficit hyperactivity disorder.
In an interview with MSDF, Harrington, whose background is in studying circadian rhythms, said that patients often don’t report fatigue to their physician because it seems hopeless. Currently, no effective treatments exist for fatigue.
One possible reason that it’s been so difficult to get a handle on the biology of fatigue is that researchers may have been looking in the wrong place. It could be that fatigue originates in the immune system, not in the nervous system. Harrington pointed out that the diseases characterized by fatigue have one major common denominator: inflammation. Harrington said that she decided to target IL-1β after reviewing the literature and work done in a model for fatigue used in rats.
In the rat model, researchers give the rats a compound called PolyIC. “It’s a viral mimic so your body thinks you’re having a viral infection,” Harrington said to MSDF. “When researchers tried to reverse the effects of PolyIC they realised that they could do it with a blocker of interleukin-1β.”
Harrington said that more work needs to be done to verify her work. But she hopes the model can help illuminate key players in generating fatigue and can be used for drug screening. She said she hopes that MS researchers will use it to help defeat the most debilitating symptom of MS.
Key open questions
How can this model be used to best serve MS research? Can it be combined with experimental autoimmune encephalomyelitis (EAE)? Why does fatigue result from inflammation, and how can it be best treated?
Disclosures and sources of funding
Harrington’s work was supported by NIH grant R21NR012845. She reported no conflicts of interest.
References
Editors' Pick
Inflammation-induced fatigue: Exploring neurobiological mechanisms and potential treatments BONSALL D, Kim H, PETRONZIO AM, MOLYNEUX PC, SCAMMELL TE, HARRINGTON ME Society for Neuroscience 2014. 11/18/2014.
Source: Multiple Sclerosis Discovery Forum Copyright © 2014 MGH
There’s a new animal model coming down the pike that may be of use to multiple sclerosis researchers. At the Society for Neuroscience (SfN) annual meeting in Washington, D.C., researchers announced that they have developed a new mouse model for fatigue. This is the first mouse model to isolate fatigue from other symptoms.
Fatigue is said to be the most common and debilitating symptom of multiple sclerosis. It’s characterised less as sleepiness and more as an inability to function normally, even if the motivation is there.
“Surprisingly, this is an underrepresented area of research,” Mary Harrington, Ph.D., of Smith College said at an SfN press conference. “There is little to no understanding of what is the underlying neurobiology of fatigue.”
The model
The researchers began by activating the pro-inflammatory cytokine interleukin-1β (IL-1β) in young, middle-aged, and aged female mice. The animals demonstrated signs of fatigue, without any other signs of sickness (Bonsall et al, 2014). Middle-aged (6 to 12 months old) and aged mice (18 to 24 months old) almost completely stopped voluntary wheel-running compared to their baseline activity. They did not, however, show signs of fever, muscle ache, or anhedonia (decreased pleasure-seeking activity). The researchers saw no significant change in the young (3- to 5-month-old) mice.
The researchers also found that the treatment did not seem to act upon the neurotransmitter orexin to induce fatigue. Orexin is thought to mediate arousal and wakefulness. Unsurprisingly, the mice also did not respond well to medications that work on the arousal system, such as modafinil (Provigil, Teva Pharmaceuticals) or methylphenidate (Ritalin, Concerta, and others), a drug commonly prescribed to treat attention deficit hyperactivity disorder.
In an interview with MSDF, Harrington, whose background is in studying circadian rhythms, said that patients often don’t report fatigue to their physician because it seems hopeless. Currently, no effective treatments exist for fatigue.
One possible reason that it’s been so difficult to get a handle on the biology of fatigue is that researchers may have been looking in the wrong place. It could be that fatigue originates in the immune system, not in the nervous system. Harrington pointed out that the diseases characterized by fatigue have one major common denominator: inflammation. Harrington said that she decided to target IL-1β after reviewing the literature and work done in a model for fatigue used in rats.
In the rat model, researchers give the rats a compound called PolyIC. “It’s a viral mimic so your body thinks you’re having a viral infection,” Harrington said to MSDF. “When researchers tried to reverse the effects of PolyIC they realised that they could do it with a blocker of interleukin-1β.”
Harrington said that more work needs to be done to verify her work. But she hopes the model can help illuminate key players in generating fatigue and can be used for drug screening. She said she hopes that MS researchers will use it to help defeat the most debilitating symptom of MS.
Key open questions
How can this model be used to best serve MS research? Can it be combined with experimental autoimmune encephalomyelitis (EAE)? Why does fatigue result from inflammation, and how can it be best treated?
Disclosures and sources of funding
Harrington’s work was supported by NIH grant R21NR012845. She reported no conflicts of interest.
References
Editors' Pick
Inflammation-induced fatigue: Exploring neurobiological mechanisms and potential treatments BONSALL D, Kim H, PETRONZIO AM, MOLYNEUX PC, SCAMMELL TE, HARRINGTON ME Society for Neuroscience 2014. 11/18/2014.
Source: Multiple Sclerosis Discovery Forum Copyright © 2014 MGH
No comments:
Post a Comment