Sunday, 29 July 2012

Survey results: cognition


"Unfortunately, our blogger polls can only give us headline results. We would need to study this in more detail to get an idea of the particular cognitive problems MSers who read this blog are having. I would be interested to find out!"




"These results have important implications and are telling us that heathcare professionals are either not aware of the problem or they are avoiding discussing one of the major hidden disabilities of MS with you. I suspect we do this as we don't have effective treatments for MS-related cognitive impairment. Should this be a reason for not telling MSers about this problem?"

"I personally believe there is a time when all MSers need to know about the potential impact MS has can have on their lives and this includes the effect on cognition. Why? This information may help you when making a treatment about treatment; early aggressive treatments may be more desirable to someone with MS if they can prevent or substantially slow the development of cognitive impairment."

"I also believe that cognitive impairment is the main driver of early social disability in MS; loss of employment, breakdowns in relationships, depression and fatigue. Unfortunately, we don't have the tools to investigate and manage these problems in our routine clinics, but things are changing."

"I have been lobbying Pharma that the biggest unmet symptomatic needs in MS are cognitive impairment and fatigue, and that they should be developing drugs for these indications. Would you agree?"

"If you are a MSer at the Royal London Hospital please sign-up for our cognition study!"

7 comments:

  1. There has been a very very small study that suggested testosterone treatment in men with RRMS offered some 'significant' impact on cognition.

    This seems to fit into other research that links testosterone to neuro-protection.

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  2. I really don't wonder about cognition problems in MS, there is slowed perfusion in MS brain. Poor flow = lots of problems.

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  3. "I really don't wonder about cognition problems in MS, there is slowed perfusion in MS brain. Poor flow = lots of problems".

    I believe this is denial, just look at the many items on the Blog, the images from MRI showing shrinkage, the pathology, etc.

    Sorting flow will not create tissue that is no longer there. Some of you will say that lack of flow is causing the problems....I will ask...show me the definative evidence.

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  4. Re: "I really don't wonder about cognition problems in MS, there is slowed perfusion in MS brain. Poor flow = lots of problems."

    Chicken or Egg?

    A lot of us would argue that the neurodegenerative processes in MS that cause a loss of nerve cells leads to a reduction in the oxygen and energy requirements of the brain that then leads to reduced blood flow. There is no evidence that the reverse occurs, i.e. reduced blood flow leads to neurodegeneration. The latter scenario is what happens with cerebrovascular disease and stroke.

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  5. I bet hypoperfusion is chicken. Future studies will prove. You wanna bet? :)

    "This pilot study is the first to report a significant relationship between the severity of CCSVI and hypoperfusion in the brain parenchyma. These preliminary findings should be confirmed in a larger cohort of MS patients to ensure that they generalize to the MS population as a whole. Reduced perfusion could contribute to the known mechanisms of virtual hypoxia in degenerated axons."

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  6. Uuups, my poor english, I meant vascular problems are chicken and hypoperfusion egg :)

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  7. You may want to check out a book by MSer Jeffrey Gingold who wrote: Facing the Cognitive Challenges of MS, 2nd Edition." A game changer in the discussion of MS cognition with professionals and family members. Also check out his interview videos on the MS Trust U.K. web site. Very useful tools to cope. Read it and then give it to your Dr.

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