Studies Uncover Possible New Factors That Alter a Person’s Risk for Developing MS

Two recent studies have uncovered new lifestyle factors that may influence whether a person develops multiple sclerosis or not:

Harvard researchers -- including National MS Society-funded Dr. Cassandra Munger -- reported that children whose mothers were deficient in vitamin D during pregnancy may have nearly twice the risk of developing MS. Additional research is needed to confirm and understand this finding. 

• Read more on Endocrinology Advisor
• Read the free-access journal article

On the flip side, researchers at the Karolinska Institute in Sweden and Johns Hopkins University reported that people who drank about four cups of coffee daily had a lower risk of developing MS compared to those who did not drink coffee. Further research is needed to understand this link.  

• Read more on CBS News
• Read the free-access journal article 

MORE: Research on risk factors is complicated, and cause and effect are difficult to establish. It's important to note that not every mother with low levels of vitamin D will have a child who develops MS, and not everyone who drinks large amounts of coffee will avoid developing MS.

Read more about risk factors for MS

Brain-training Video Games May Help MS Patients

A new study suggests that playing a certain kind of video game strengthens neural connections in the brains of people with multiple sclerosis, improving cognitive abilities. Researchers hope to study whether the plasticity induced by video games in MS patients is linked to improvements in other aspects of their daily lives. They also plan to look at how the video game can be integrated into a rehabilitation program.

Researchers, led by Dr. Laura De Giglio, from the Department of Neurology and Psychiatry at Sapienza University in Rome, studied the effects of a video game-based cognitive rehabilitation program on the thalamus in patients with MS. They used a collection of Nintendo video games, called Dr. Kawashima's Brain Training, which train the brain using puzzles, word memory and other mental challenges.

Twenty-four MS patients with cognitive impairment were randomly assigned to either take part in an eight-week, home-based rehabilitation program — consisting of 30-minute gaming sessions, five days per week — or be put on a wait list, serving as the control group. Patients were evaluated by cognitive tests and by 3-Tesla resting state functional MRI at baseline and after the eight-week period. At follow-up, the 12 patients in the video-game group had significant increases in thalamic functional connectivity in brain areas corresponding to the posterior component of the default mode network, which is one of the most important brain networks involved in cognition.

The modifications in functional connectivity shown in the video game group after training corresponded to significant improvements in test scores assessing sustained attention and executive function. The results suggest that video-game-based brain training is an effective option to improve cognitive abilities of patients with MS.

Researchers Funded by National MS Society Pinpoint Direct Damage to Nerve Connections in Mice, Independent of Myelin Damage

Summary

• Researchers have found evidence that microscopic connectors in the brain called “synapses” are directly damaged during the course of MS-like disease in mice, in an area of the brain linked to cognitive function.
• The damage appeared to be unrelated to myelin damage, and was linked  to a specific molecule called platelet-activating factor receptor.
• Further research will determine whether treatment that protects synapses in the hippocampus may preserve cognitive function in people with MS. The team is pursuing therapeutic candidates based on these findings.
• This research was funded in part by a National MS Society-American Brain Foundation (American Academy of Neurology) Clinician Scientist Development Award to Dr. Matthew Bellizzi.
• The team (Drs. Bellizzi, Harris Gelbard, and colleagues, from the University of Rochester Medical Center, in New York) has published results in The Journal of Neuroscience. (2016 Jan 27;36(4):1336-46.) 

Background:  MS involves immune attacks in the brain and spinal cord. During the course of MS, damage  occurs to the myelin that surrounds and protects nerve fibers, and nerve cells and their axons are also damaged.  Damage to nerve cells in MS has been linked to cognitive impairment, progressive disability and other symptoms.

The causes of nerve damage are not yet well understood, which has limited progress in developing therapies that prevent damage and preserve nerve function (neuroprotection) to slow or stop progressive disability. Some research has shown that microscopic connectors in the brain called “synapses” may be lost in some parts of the brain during the course of MS, but details have been lacking. Synapses are the point of communication between individual nerve cells, and they are critically important for all functions of the nervous system including memory. A  team at the University of Rochester has been attempting to determine the extent of damage to nerve cell fibers and synapses in brain, to find ways to protect nerves from damage.

The Study:  The team, led by Matthew Bellizzi, MD, PhD, and Harris Gelbard, MD, PhD (University of Rochester), studied mice with the MS-like disease EAE. They measured the density of synapses in an area of the brain called the hippocampus. The hippocampus is involved in memory function. Although myelin was preserved, synaptic density was reduced by 28%, compared with mice that did not have EAE.

In another study, the team grew nerve cells from the hippocampus in laboratory dishes, and then added brain cells called microglia. This made the synapses more vulnerable to damage, and this damage seemed to be dependent on signals from a molecule called platelet-activating factor receptor (PAFR). To test this, the team administered an experimental molecule – BN52021 – that inhibits PAFR. Administering this molecule before EAE developed did not prevent the disease, but preserved synapses.

This research was funded in part by a National MS Society-American Brain Foundation (American Academy of Neurology) Clinician Scientist Development Award to Dr. Matthew Bellizzi. The team published results in The Journal of Neuroscience. (2016 Jan 27;36(4):1336-46.)

Next Steps:  Further research will determine whether treatment that preserves synapses in the hippocampus can improve cognitive function in people with MS. According to a press release from the University of Rochester, the researchers are now focused on exploring potential therapeutic candidates based on these findings.

Read more about research to repair damaged tissue in MS
Read more about efforts to understand how MS affects cognitive function
Watch the educational video, Mood & Cognition in MS: [What you can do].