Talk:Multiple sclerosis

No mention of role of MSRV/HERV virus

There is a considerable amount of literature that mentions the MSRV virus as possibly playing a role in the progression of the disease. There are even clinical trials on possible treatment options involving the suppression of HERV-family viruses. Anyone with a medicine/virology background who can have a look at these data?

Some other links:

• http://www.ncbi.nlm.nih.gov/pubmed/23308264
• http://www.direct-ms.org/sites/default/files/MS_Retrovirus.pdf
• http://www.geneuro.com/en/technologies/rationale.php

Coldpac (talk) 17:33, 13 December 2014 (UTC)

No mention of LDN which is used by some patients as one of alternative therapies

I believe it should be mentioned if we mention acupuncture and other.

See links:

• http://www.nationalmssociety.org/Treating-MS/Complementary-Alternative-Medicines/Low-Dose-Naltrexone
• http://www.mssociety.org.uk/ms-news-and-research/ms-research/potential-treatments/emerging-areas-of-research/ldn

Anonymous, 9:55, 11 January 2015 (UTC)

Inclusion of role of the microbiome in MS?

Before making any substantial additions to the article, I wanted to see if others who are familiar with this topic believe it would be wise to add in material (supported by WP:MEDRS reviews of course) discussing the idea that the disturbances/alterations in the micro biome may be influential in the autoimmunity underlying MS. I saw a few reviews about it on PubMed and am in the process of looking over one (I crashed into a paywall when I attempted to read the other), but I would like to hear a few other opinions if anyone cares to comment. Thanks! TylerDurden8823 (talk) 08:01, 12 October 2014 (UTC)

Bueller? TylerDurden8823 (talk) 05:29, 15 October 2014 (UTC)

Okay then, I haven't heard any objections so I'll add this material in the near future. TylerDurden8823 (talk) 00:18, 7 November 2014 (UTC)

It seems that a section about the microbiome never has been added. There is currently growing research about the influence of the Microbiome. Below an initial draft with some references. I do not have permissions to change this article, so I will not add it:

There is some evidence that the microbiome has an effect on the disease. There exist both gut microbes that seem to prevent autoimmune reactions and microbes that seem to promote them. For persons with MS the latter kind seems to be more frequent that the first. . Due to these results it has been speculated that both the diet and Antibiotics could have an effect on the disease.

References

Gydoen (talk) 17:03, 10 January 2016 (UTC)

Suicide?

You may have to excuse me because I am relatively new to the editing side of wikipedia and do not understand most of the formalities behind what is or is not done to articles. However, I am concerned by the presence of a suicide statistic for MS in this article. A. I do not understand how knowing this factoid is helpful for anyone who might be visiting this page, besides perhaps as a qualifier for the life expectancy value; and B. my intuition is that any sort of mention of suicide subconsciously increases the likelihood that someone will actually commit suicide, particularly when a correlation is stated between suicide and some condition that the reader may find sympathetic. All I'm saying is: why include it? what value does it bring to the reader? if none, I suggest it is dangerous, if only trivially. Is there a precedent or policy related to this sort of thing? Again, I'm new here. Any help/information/response is appreciated.

94% of medical students read Wikipedia. This will hopefully remind them to ask people with MS about suicidal thoughts so that they can than arrange the help they may need thus reducing the risk of suicide. Doc James (talk · contribs · email) 06:33, 20 November 2014 (UTC)

Also, the notion that mention of suicide increases the risk of suicide has been examined before and been found to be false. I agree with James' comment that medical professionals and students alike will benefit from such knowledge as might friends and family of individuals who suffer from multiple sclerosis since it may help them to understand the depth of MS sufferers' burden more completely. TylerDurden8823 (talk) 07:59, 20 November 2014 (UTC)

Proposed merge with Vision problems in multiple sclerosis

Excessive focus on one set of symptoms. No independent evidence that this aspect is notable as a stand-alone topic or specific to this disease (vs other similar neurological disorders). Is written as a stand-alone essay (mostly focusing on defining the terms, but we already have articles on each symptom), so there's little that's actually about relationship with MS. DMacks (talk) 16:18, 11 December 2014 (UTC)

• Nothing to merge, no good sources. Redirect to Multiple sclerosis Multiple sclerosis signs and symptoms. DMacks, since MS is a Featured article, would you mind removing the tag from the top of the article and placing it instead on the talk page? It's unfortunate that an FA is tagged/defaced because of this one essay. SandyGeorgia (Talk) 16:21, 11 December 2014 (UTC)

 Done. DMacks (talk) 16:25, 11 December 2014 (UTC)

Should be merged here Multiple sclerosis signs and symptoms if anywere. Doc James (talk · contribs · email) 04:53, 12 December 2014 (UTC)

• Redirect, no content that needs merging. I am going to be BOLD and remove that box, as per SandyGeorgia JFW | T@lk 09:36, 17 December 2014 (UTC)

 Done Nobody objected to merge+redirect and multiple others said there was nothing specific to merge and agreed with a specific target, so I just redirected it. Anyone interested in trying to fish out some details to put into some other article is welcome to look at the history. DMacks (talk) 06:35, 5 January 2015 (UTC)

Improvements to Use of language

I can spot several places in the text where improvements could be made to the form of expression used:

1)1st paragraph; 'myelin' should be mentioned in relation to 'insulating sheath'. This would explain the use of 'myelin' in the 2nd para.

2) Para 3: 'lack of evidence' of what ?. Should read 'lack of evidence of their effectiveness'.

4) Signs & Symptoms: '..difficulties thinking..' should read '...difficulties with thinking...'

5) '... previous difficulties..' should be '..previously mentioned difficulties...', or better still '.. these difficulties...'.

6) Causes: what does it mean to 'modify' an environmental factor ? 'Avoidable' is probably what is intended.

7). Geography. 'home country' is ambiguous in the context. 'Native' is probably intended (i.e. country of birth). — Preceding unsigned comment added by 77.96.60.31 (talk) 10:50, 4 January 2015 (UTC)

Hi, thanks for your valuable remarks, these are all non-controversial changes, feel free to fix the things yourself :) Regards, kashmiri ^TALK 00:01, 5 January 2015 (UTC)

Preactive lesions

It seems stablished that the earlier stage of a MS lesion is a cluster of activated microglia in a NAWM area. There is a review from 2009 summarizing these findings [1].(van der Valk P, Amor S. Preactive lesions in multiple sclerosis. Curr Opin Neurol. 2009 Jun;22(3):207-13. doi: 10.1097/WCO.0b013e32832b4c76. PMID 19417567)

As far as I know this description of the lesion starting process has not been disputed during the last four years. Could it be included into the lesion evolution section?:--Juansempere (talk) 11:16, 6 January 2015 (UTC)

Chlamydia pneumoniae as an Infectious Agent

I would like to propose that Chlamydia pneumoniae be added as a proposed infectious agent. The following references are studies which have found a significantly higher incidence of C. pneumoniae in M.S. patients.

Sriram, S., Stratton, C. W., Yao, S.-Y., Tharp, A., Ding, L., Bannan, J. D., & Mitchell, W. M. (July 01, 1999). Chlamydia pneumoniae infection of the central nervous system in multiple sclerosis. Annals of Neurology, 46, 1, 6-14.

Munger, K. L., Peeling, R. W., Hernán, M. A., Chasan-Taber, L., Olek, M. J., Hankinson, S. E., Hunter, D., ... Ascherio, A. (March 01, 2003). Infection with Chlamydia pneumoniae and Risk of Multiple Sclerosis. Epidemiology, 14, 2, 141-147.

Any high quality review articles from the last 5 years? Doc James (talk · contribs · email) 21:55, 12 February 2015 (UTC)

Sources

Lancet Neurology:

• doi:10.1016/S1474-4422(14)70267-4 - environmental factors
• doi:10.1016/S1474-4422(14)70250-9 - cognitive assessment (clinical and imaging)

May be useful for updating, particularly the top one which is a review of reviews and casts doubts on some associations for environmental causation. JFW | T@lk 12:47, 17 February 2015 (UTC)

MansourJE (talk) 12:31, 27 March 2015 (UTC)

Demyelinating diseases

Demyelinatiation may cause lot's of problems in the patient own body. However, mylination can happen under certain circumstances. Read more here:

http://medicalxpress.com/news/2015-03-myelinate-nerve.html?utm_source=nwletter&utm_medium=email&utm_content=splt-item&utm_campaign=daily-nwletter

MansourJE (talk) 18:00 27 March 2015 (UTC)

MansourJE (talk) 04:52, 21 April 2015 (UTC)

Catalyzing body's own immune cells system

One of the purposes of the current multiple sclerosis's drugs is to alleviate the pains that is in the muscles. However, recent research desires to catalyze body's own immune cell lost to be replaced.

Read more:

http://medicalxpress.com/news/2015-04-drugs-body-stem-cells-brain.html?utm_source=nwletter&utm_medium=email&utm_content=splt-item&utm_campaign=daily-nwletter

MansourJE (talk) 09:17 21 April 2015 (UTC)

I don't think you have necessarily understood the nature of MS or what the article is proposing. JFW | T@lk 22:57, 21 April 2015 (UTC)

Semi-protected edit request on 7 May 2015

Changing:

There are several historical accounts of people who lived before or shortly after the disease was described by Charcot and probably had MS.

to:

There are several historical accounts of people who probably had MS and lived before or shortly after the disease was described by Charcot.

might improve clarity. Nolanamy (talk) 20:39, 7 May 2015 (UTC)

Done Stickee (talk) 02:01, 8 May 2015 (UTC)

ABN guidelines on disease-modifying treatments

UK guidance on interferons, glatiramer etc. doi:10.1136/practneurol-2015-001139 JFW | T@lk 07:59, 17 July 2015 (UTC)

30 years

"been known for over thirty years" refers to a period of over 30 years ending 2012. So it may be better and safe to say "since the 1980s", which will be less confusing in years to come. JMK (talk) 12:02, 19 August 2015 (UTC)

Agree User:JMK excellent suggestion. Doc James (talk · contribs · email) 15:23, 19 August 2015 (UTC)

Cost of Medical Dimethyl Fumarate vs. chemical

I am aware that the wholesale cost of Tecfidera (anti-Multiple Sclerosis drug; only ingredient is dimethyl fumarate, apparently) is $109 per 240 milligram capsule. An ordinary dose is one capsule per day, and thus a cost of about $40,000 per year. https://www.biogen.com/content/dam/corporate/en_us/pdfs/vermont-pricing-disclosure/3.18.2015.long-form-tecfidera.pdf Yet, Sigma-Aldrich sells dimethyl fumarate at $64 per 100 grams http://www.sigmaaldrich.com/catalog/search?term=Dimethyl+fumarate&interface=Product%20Name&N=0+&mode=mode%20matchpartialmax&lang=en&region=US&focus=productN=0%20220003048%20219853286%20219853269 , equivalent to over 400, 240 milligram capsules. (and Sigma-Aldrich isn't exactly known as a low-cost supplier, either!) In other words, a cost of about 16 U.S. cents per capsule, making Tecfidera about 700x more expensive. I'm very new to editing WP; but I think it would be desireable to include these facts in the dimethyl fumarate (and Multiple Sclerosis) articles. I understand that ideally, this would involve the use of secondary sources, but in some situations the use of primary sources (including those I've listed above) might be appropriate as well. Could somebody who is interested in this help me out here? Sluefoot (talk) 18:35, 7 September 2015 (UTC)

You would need a medical source which says this is possible / recommended. We do sometimes include info like this such that we often use the iv solution of vancomycin rather than the pills because the iv solution is cheaper. Doc James (talk · contribs · email) 21:08, 7 September 2015 (UTC)

Semi-protected edit request on 23 November 2015

please add information about HSCT for MS - it has been in clinical trials for MS for the last 15 years in USA and 12 years in Canada. http://themscure.blogspot.ca/2010/06/stem-cell-transplantation-reference.html https://en.wikipedia.org/wiki/Hematopoietic_stem_cell_transplantation it is readily available - worldwide - but only if you pay for it or if you fit into the narrow NCT clinical trials. http://www.hsctstopsms.com/hsct-facilities-worldwide/ It is the same procedure as the procedure for cancer patients up to age 65 since the 1960's - chemotherapy followed by stem cell transplant. The stem cells are most commonly obtained from the patients own bone marrow. They are usually extracted by medications that drive the stem cells out of the bone marrow and into the blood stream which is then extracted and saved until after the patient completes chemo, then reinfused. Thank you. This is critical information that is not publicized much as there is no profit in this procedure as it halts MS.

2001:569:739F:4A00:C0D5:7864:C8A1:EC8D (talk) 18:24, 23 November 2015 (UTC)

Is their a review article that discuses? Please see WP:MEDRS. best Doc James (talk · contribs · email) 11:44, 24 November 2015 (UTC)

A bit dated but PMC 3448948 is à propos. LeadSongDog come howl! 14:17, 24 November 2015 (UTC)

Under discussion, disable template Mdann52 (talk) 17:03, 4 December 2015 (UTC)

peginterferon beta-1a was FDA Approved in 2014

In the Research section it is listed that peginterferon beta-1a would seek approval in 2013. Well, it did: http://www.nationalmssociety.org/About-the-Society/News/FDA-Approves-Plegridy-Pegylated-Interferon-Beta LoioshDwaggie (talk) 13:38, 24 November 2015 (UTC)

Chronic cerebrospinal venous insufficiency

I propose to add this new source:

Chronic Cerebrospinal Venous Insufficiency in Multiple Sclerosis: A Failed Concept. Vasc Specialist Int. 2015 Mar;31(1):11-4. doi: 10.5758/vsi.2015.31.1.11. Epub 2015 Mar 31. Kugler N, Patel PJ2, Lee CJ

PMID:26217638 PMC:4480289

Best regards. --BallenaBlanca (talk) 13:45, 5 January 2016 (UTC)

Effectiveness of immunotherapy for RRMS

doi:10.1001/jama.2015.18984 JAMA clinical evidence synopsis JFW | T@lk 08:23, 27 January 2016 (UTC)

Medical Cannabis

Here is the text of the source in question:

" 4. Summary

The beneficial therapeutic effects of cannabinoids and potentially the endocannabinoids in symptom management in MS can now be said to be proven, particularly for symptoms such as spasticity. The potential for cannabis in slowing disease progression in MS is less clear, but experimental evidence clearly suggests that cannabis and the endocannabinoids are definitely neuroprotective, and the findings of a single clinical trial performed with THC capsules, though certainly not definitive, do suggest that there was a neuroprotective benefit in a sub-group of patients with a lower initial level of disability (although the numbers in this group were too low for a definitive conclusion). Such a clinical trial needs to be repeated in a larger group of MS patients with lower levels of disability on entering the study. In ALS, the field is some years behind that of MS. Experimental studies do point to a potential role of cannabis and the endocannabinoids in the management of this disease, particularly with regard to symptoms such as pain and spasticity, but also potentially in the modification of disease progression, and the need for clinical trials in this area to investigate this is indicated."

Psyden (talk) 00:24, 27 March 2016 (UTC)

That is not about "medical cannabis", which is what you wrote. That is about nabiximols and cannador which is a specific THC extract from cannabis. I started back on Management of multiple sclerosis as you should have and am working my way here. Jytdog (talk) 00:26, 27 March 2016 (UTC)

As defined by wikipedia: "Medical cannabis, or medical marijuana, refers to the use of cannabis and its cannabinoids to treat disease or improve symptoms"Psyden (talk) 06:16, 27 March 2016 (UTC)

This source is not making general claims about "medical cannabis". It talks very specifically about two interventions in the context of MS, as I mentioned above. Additionally, Wikipedia articles are not reliable sources. I just tagged that sentence and asked on the talk page what its source is. Jytdog (talk) 08:07, 27 March 2016 (UTC)

Source added. What phrasing would you propose? Psyden (talk) 13:55, 27 March 2016 (UTC)

I am struggling with that. Like I said we have Management of multiple sclerosis which is a WP:SPLIT from this article. Per WP:SYNC the section on management in this article really should be be the lead of that article, with sources added. I am trying to get time to review that article in comparison with the section here to get that article brought up to date, and its header brought up to date, so it can be brought over here. It is not clear to me if the use of THC and Nabiximols is important enough to rise to the lead of that article and so whether it should be included in this article at all. There is a lot of work to do. Jytdog (talk) 20:51, 27 March 2016 (UTC)

New drug-free treatment/cure for multiple sclerosis: FMD (fasting mimicking diet)

The media have reported a new cure for MS (tested extensively in mice, and in a small pilot study of humans) and the authors recommend its immediate application. Can someone read the paper (Cell Report June 2016) and implement it into the Wikipedia article? The media version is as follows (The Telegraph, 1 June 2016, I have corrected the punctuation):

Scientists from the University of Southern California showed that in mice, the Fasting Mimicking Diet (FMD) significantly lowered the percentage of damaging immune cells, while allowing the protective coating to regrow.

Human MS patients, who were put on the diet to check that it was not harmful to their health, also reported improved quality of life and scored better on the Extended Disability Status Scale (EDSS) which assesses movement, tremors, speech and swallowing.

Prof Walter Longo, the study’s lead author and professor who directs the USC Longevity Institute said: “The effect on humans was improvements for both quality of life and EDSS, which is remarkable because we only did a single cycle of the FMD for humans and tested them three and six months after.

“Since the pilot human trial was small, now we are setting up a large multi-center clinical trial. However, because we have already tested this and similar diets on hundreds of patients with various diseases, I believe this can be tried now by MS patients who cannot wait.”86.154.102.141 (talk) 15:59, 1 June 2016 (UTC)

Please read WP:MEDRS. We would need a review article. Doc James (talk · contribs · email) 16:03, 1 June 2016 (UTC)

Thanks, Doc and Kashmiri. I have read the Wikipedia guideline and to me it does not sound quite so absolute. But I suggest you leave my section here for a while to await confirmatory studies/reviews etc over the next 12 months. If no confirmation is forthcoming, feel free to archive this. — Preceding unsigned comment added by 86.154.102.141 (talk) 16:29, 1 June 2016 (UTC)

Curcumin

Please add curcumin as an example of still unconfirmed (but promising) herbal remedy. I would do it but the article is locked. It can be added under subsection "Alternative treatments" in the parentheses that mention medical cannabis. Here is the source:

Xie, Lin, Xiao-Kang Li, and Shiro Takahara. "Curcumin has bright prospects for the treatment of multiple sclerosis." International immunopharmacology 11.3 (2011): 323-330. — Preceding unsigned comment added by 131.211.211.65 (talk) 15:17, 2 July 2016 (UTC)

 Not done. Medical information should come from SECONDARY sources, please read this guideline. — kashmiri ^TALK 22:29, 2 July 2016 (UTC)

I did write "as an example of still unconfirmed (but promising) herbal remedy." Since there is already a section titled "Alternative treatments" in the article and it references medical cannabis as an example, it could also mention curcumin. 62.195.45.181 (talk) 12:33, 28 July 2016 (UTC)