Life In Multiple Sclerosis Patients Research Articles

The Role of Iron Metabolism in Fatigue, Depression, and Quality of Life in Multiple Sclerosis Patients.

Multiple sclerosis (MS) is a chronic inflammatory disease of autoimmune origin for which there is currently no available cure. In the course of MS, next to neurological disorders, patients often present with chronic fatigue syndrome and depressive disorders, which impact on their daily function and quality of life. The aim of study was to analyse the relationship between serum parameters of iron metabolism and the severity of fatigue, depressive symptoms, and quality of life in MS patients. Methods: The study sample consisted of 90 people with a diagnosis of multiple sclerosis, age range 19–67 years, whose functional status evaluated using the Expanded Disability Status Scale in 90% of the participants did not exceed 3.5 points. Venous blood samples were collected for blood cell count determination and for the purposes of obtaining serum analysed for the concentrations of iron, ferritin, transferrin, transferrin saturation, unsaturated iron binding capacity (UIBC), and total iron binding capacity (TIBC). The participants were also evaluated according to the Fatigue Severity Scale, Beck Depression Inventory, and Functional Assessment of Multiple Sclerosis. Results: Ferritin levels were significantly correlated with the severity of depressive symptoms (r = −0.22; p = 0.04) and quality of life assessment (r = 0.22; p = 0.04) in the MS patients. Moreover, the severity of fatigue and depressive symptoms was significantly linked to a deterioration in quality of life. Conclusions: Ferritin deficiency in MS patients is associated with an exacerbation of depressive disorders and a decline in quality of life. Symptoms of fatigue in MS patients are inversely proportional to mood and quality of life.

Evaluation of Lower Urinary Tract Dysfunction Impact on Quality of Life in Multiple Sclerosis Patients: Russian Translation and Validation of SF-Qualiveen.

The Short Form Qualiveen (SF-Qualiveen) is an 8-item version of the Qualiveen questionnaire used to evaluate the impact of urinary symptoms on the quality of life in patients with urological dysfunction due to neurological disorders. The questionnaire was never available in the Russian language before. The study is aimed at providing the translation, cultural adaptation, and validation of a Russian version of the SF-Qualiveen for the use in patients with multiple sclerosis (MS). Materials and Methods. The original English language version of the SF-Qualiveen was translated into Russian according to the cultural and linguistic adaptation algorithm. The participants (50 MS patients with neurogenic bladder and 10 relatively healthy volunteers) filled out the finalized Russian version of the SF-Qualiveen and the Neurogenic Bladder Symptom Score (NBSS) twice, 2 weeks apart. The data obtained was used to determine the internal consistency (Cronbach's alpha), external validity (the Spearman correlation), and test-retest reliability (intraclass correlation coefficient (ICC)) of the questionnaire. Results. The mean SF-Qualiveen total score was 2.51 ± 0.79 in patients with a neurogenic bladder and 0.1 ± 0.02 in the control group (p < 0.001). Cronbach's alpha exceeded 0.9 indicating an excellent internal consistency of the questionnaire. The retest did not reveal any significant differences between the findings. The test-retest reliability was good for all items and domains (ICC 0.81-0.89). The total score demonstrated the highest ICC (0.89). The external validity was verified by a strong correlation demonstrated between the SF-Qualiveen and NBSS scores. Conclusions. The Russian SF-Qualiveen questionnaire is a reliable, valid, and consistent tool for the assessment of a urinary disorder impact on the quality of life in patients with MS.

Health Management for Quality of Life of Multiple Sclerosis Patients

Abstract Objectives The purpose of this study is to investigate the associations of health behaviors such as diet, sleep and physical activity with quality of life (QoL) for adults diagnosed with Multiple Sclerosis (MS) and other major chronic diseases. The study hypothesizes that healthier diet in addition to an increased level of physical activity is associated with improving overall quality of life for those with MS. Methods The study includes adults aged 40 and older who are registered members of the Michigan Athletic Club in East Lansing, MI, diagnosed with MS, Parkinson's Disease or Arthritis (n = 30). Data on demographic information, previous health history and health behaviors such as mental health, diet, sleep and physical activity are collected. Multivariate regression models are analyzed in order to describe how current health behaviors are associated with quality of life for those with chronic conditions. Results Study results show that physically active MS patients with proper amount and better quality of sleep are likely to have higher overall quality of life. Healthier diet in addition to an increased level of physical activity is also likely to improve overall quality of life for those with MS. Conclusions When the importance of diet, exercise and sleep on MS is understood by the medical community, MS patients can utilize this information to improve their QoL through their own habits. Therefore, this study could lead to better management of symptoms by healthcare professionals and patients, and an improved QoL for those diagnosed with MS. Funding Sources N/A.

Assessment of the Quality of Life of Multiple Sclerosis Patients' Caregivers in Saudi Arabia

Multiple sclerosis (MS) has been found to impact the quality of life of caregivers. Although many studies have assessed the quality of life of MS caregivers worldwide, no such studies have been conducted in Saudi Arabia. In this study, we aim to assess the quality of life of MS patients' caregivers in Saudi Arabia. This cross-sectional study included caregivers of MS patients (for >1 year) who visited the neurology clinic at King Abdulaziz Medical City, Jeddah, Saudi Arabia between July 2017 and December 2018. The study utilized the Zarit Burden Interview (ZBI) to assess the burden on MS patients' caregiver. In addition, their demographic profile was collected, and certain information regarding the patient was also collected through an oral interview. There were a total of 219 respondents, of which 117 (53.4%) male caregivers. For ZBI, the majority of caregivers reported little or no burden (57.1%), followed by mild to moderate burden (30.1%), then moderate to severe burden (10.5%), and only 5 (2.3%) reported severe burden. Our results showed limited impact of MS on the quality of life of caregivers of MS patients. We stress on the importance of routine assessment of the quality of life in MS patients and caregivers as routine practice with the other important measures. The finding of this study will help in encouraging medical centers to establish more specialized MS clinics that put into consideration the psychological factors.

Factors affecting MS patients' health-related quality of life and measurement challenges in Lebanon and the MENA region.

BackgroundIn the Middle East and North Africa (MENA) region, few studies explored the quality of life of multiple sclerosis patients and the factors affecting it.ObjectiveThe objective of this study was to explore studies on multiple sclerosis quality of life in the MENA area through a comprehensive literature review. To validate the Multiple sclerosis international Quality of Life (MusiQoL) and Modified Fatigue Impact Scale (MFIS) in Arabic, and investigate the impact of sociodemographic and clinical variables of Lebanese multiple sclerosis patients on quality of life.MethodsAs part of an ongoing observational prospective research study, data from 663 stable multiple sclerosis patients were analysed.ResultsIn Lebanese multiple sclerosis patients, the Arabic MusiQoL and MFIS seem to be accurate and valid tools with high reliability coefficients and confirmatory factor analytic indices. Variables such as age and disease type predicted multiple sclerosis quality of life, yet were significantly affected by psychosocial fatigue. The influence of sociodemographic and clinical variables on quality of life dimensions varied. Being a woman with multiple sclerosis, receiving medications and experiencing physical fatigue worsens the psychological wellbeing quality of life dimension.ConclusionSeveral sociodemographic and clinical variables predicted the health-related quality of life dimensions of multiple sclerosis patients in MENA. Further in-depth investigation to guide more targeted clinical management is recommended. We encourage using validated multidimensional tools to measure quality of life in MENA such as the Arabic MusiQoL.

Vitamin D deficiency and its association with fatigue and quality of life in multiple sclerosis patients

Vitamin D deficiency is associated with the incidence and prevalence of a variety of neurologic disorders, including multiple sclerosis. However, available studies to date have not provided convincing evidence that vitamin D treatment improves fatigue and life quality in patients with multiple sclerosis. To assess the relationship of vitamin D deficiency with health-related quality-of-life issues and fatigue in multiple sclerosis patients. Vitamin D3 levels were measured in 149 multiple sclerosis patients. In patients with lower than 30 ng/mL levels, vitamin D was administered. Fatigue and health-related quality of life scores were measured at baseline and months 1, 3, 6, and 12 after the beginning of vitamin D3 administration. Among 149 patients, 90% were vitamin D deficient. After vitamin D supplementation, health-related quality of life and fatigue scores improved significantly. There was a direct association between health-related quality of life with absence of fatigue and vitamin D status at the end of study. The 90% frequency of multiple sclerosis patients with vitamin D deficiency, together with the significant association of vitamin D status with the absence of fatigue and improved physical and functional well-being, points to vitamin D supplementation as a potential therapy to enhance the patient's quality of life. This article emphasizes that vitamin D supplementation can improve clinical outcome in multiple sclerosis patients providing immune modulation and neuroprotection. Identification and correction of vitamin D deficiency has the potential to treat the related quality of life in patients with multiple sclerosis.

Can inpatient multidisciplinary rehabilitation improve health-related quality of life in MS patients on the long term – The Danish MS Hospitals Rehabilitation Study

Background: Inpatient multidisciplinary rehabilitation (MDR) can improve health-related quality of life (HRQoL) in multiple sclerosis (MS) patients. However, the evidence of a long-term benefit is limited. Objectives: To investigate the long-term effectiveness of inpatient MDR on HRQoL in MS patients. Methods: We conducted a randomized controlled partial crossover trial with 427 MS patients. Results: Statistical significant long-term improvements in HRQoL were found in three of the six outcome measures at 12-month follow-up. Three in four suggested minimal clinically important differences (MCIDs) were unmet. Conclusion: These results indicate that the administration of inpatient MDR may lead to long-lasting improvements in HRQoL in MS patients.

Urinary Symptoms in Multiple Sclerosis: Relation with Urodynamic Findings and Impact on Patient’s Quality of Life

Objective: We aimed to investigate the correlations of urinary symptoms with urodynamic findings in patients with multiple sclerosis (MS) and their effects on quality of life.Methods: Nineteen MS patients with urinary symptoms were included. The data were obtained from files or with face-to-face interviews. Symptom types of patients were categorized as irritative, obstructive, and mixed. The Incontinence Quality of Life Scale, the King’s Quality of Life Questionnaire (KQL) and the International Consultation on Incontinence Modular Questionnaire-Short Form were used to determine the effect of urinary symptoms on quality of life. The Extended Disability Status Scale (EDSS) was used to assess disability. All patients underwent urodynamic examination.Results: The most frequent finding in urodynamic testing was detrusor overactivity (57.9%) while 26.3% had normal urodynamics. EDSS score did not correlate with urinary symptoms or urodynamic findings; it correlated only with the “Role limitation” subscale of the quality of life scales. While there was no relationship between symptom type and quality of life, the rate of detection of pathological findings on urodynamic examination and the bladder capacity in patients with mixed-type symptoms were significantly higher than the patients with irritative symptoms (p&amp;lt;0.05). The ‘’Emotions’’ and ‘’Sleep/Energy’’ subscale scores of the KQL were significantly higher in patients with abnormal urodynamic test compared with those without urodynamic pathology.Conclusion: The urinary symptoms significantly affect the quality of life in MS patients. Since symptoms do not always correlate with the underlying pathology, it is more appropriate to give the treatment based on the bladder type in urodynamic testing.

Why physical activity improves quality of life in multiple sclerosis patients: correlation between fatigue and functional parameters

Why physical activity improves quality of life in multiple sclerosis patients: correlation between fatigue and functional parameters

Food of the gods for the treatment of multiple sclerosis related fatigue?

In their JNNP paper, Coe et al report the preliminary results of a feasibility trial on flavonoid enriched cocoa for the treatment of multiple sclerosis (MS) related fatigue, showing promising...

The Effectiveness of Emotional Self-Regulatory Model on Improving the Quality of Life in Multiple Sclerosis Patients

The Effectiveness of Emotional Self-Regulatory Model on Improving the Quality of Life in Multiple Sclerosis Patients

Tibial Nerve and Sacral Neuromodulation in the Multiple Sclerosis Patient with Voiding Dysfunction

Storage and voiding dysfunction are highly prevalent in patients with multiple sclerosis (MS). Many MS patients fail behavioral modifications and oral medications. Neuromodulation in the form of posterior tibial nerve stimulation (PTNS) and sacral neuromodulation (SNM) is a potential treatment for this group of patients. We review contemporary and impactful literature regarding neuromodulation in the MS patient with lower urinary tract dysfunction. Large-scale randomized trials regarding the use of neuromodulation in the treatment neurogenic lower urinary tract dysfunction are limited. Despite this, several small prospective studies demonstrate durable responses to neuromodulation in the MS patient. Posterior tibial nerve trials reveal improvements in urodynamic parameters, incontinence episodes, post-void residual volumes, and quality of life metrics. Additionally, SNM in the MS patient results in improvements in daytime and nighttime frequency, urgency symptom, and quality of life. Currently, the frequent need for routine spinal MRI scans precludes the use of SNM. Limited research suggests that some MRI use may be safe, but investigation in this area is ongoing. Tibial and sacral neuromodulation appear safe and offer significant improvements in lower urinary tract symptoms and quality of life in MS patients who have failed oral medications and behavioral modifications. Though randomized controlled trials are limited in this area, neuromodulation offers great promise to this often refractory and complex patient population. Future studies are warranted and necessary to better evaluate the efficacy of these treatment options.

A Group Cognitive Behavioural Therapy Improves Quality of Life of Multiple Sclerosis Patients and Delays Disease Progression: A Multi-Centre Controlled Trial

Background: Multiple Sclerosis (MS) affects quality of life (QoL). Pharmacological treatments demonstrated benefits on clinical endpoints without improving QoL. We evaluated the effects of a group Cognitive Behavioural Therapy (CBT) on QoL disease progression. Methods: One-year multi-centre controlled multivariate-matched study was organised on Relapsing-Remitting MS (RRMS) patients with Expanded Disability Status Scale (EDSS) &lt; 4, MS duration &lt; 2 years, treated by interferon I? in 11 French centres. For each new patient, the two best-matching patients for age, gender, EDSS, mood, illness duration baseline variables were selected in the other centres. The self-filled Two Lives Scale (TLS)-QoL10 was used at months (M) 0-3-6-9-12-15; the post-baseline mean QoL was the endpoint. We compared CBT + I? to I? alone. The effect of disease progression on QoL was evaluated by modelling, for each visit, the effect of EDSS on QoL at later visits.Results: 19 + 32 patients were recruited. Compared to placebo, improvements of 1.10 (95%CI [0.31-1.89], p = 0.009) and 1.43*** [0.72, 2.15] were observed in the CBT group on QoL and coping scales, respectively. Coping explained 81%*** [57, 100] of the effect of CBT on QoL. QoL was negatively affected by disease progression (0.95*** [-1.21; 0.63]), whereas EDSS was influenced by QoL values (-0.10*** [-0.14; -0.06]).Conclusions: We observed a clinically significant beneficial effect of CBT on QoL, the effect of CBT essentially explained by an increase of coping, a positive influence of QoL on disease progression. QoL is both the most important target for patients and a factor of slowing disease progression.

Effects of a physiotherapy rehabilitation program on the quality of life in multiple sclerosis patients

Effects of a physiotherapy rehabilitation program on the quality of life in multiple sclerosis patients

Evaluation of respiratory functions and quality of life in multiple sclerosis patients.

The aim of this study was to evaluate respiratory muscle strength, respiratory functions and quality of life in multiple sclerosis (MS) patients and compare the results with the healthy volunteers. The study included a group of 24 patients diagnosed with MS (16 women, 8 men) with an EDSS score of ≤ 5, who were without clinical respiratory impairment. MS patients were compared with the healthy volunteer group (16 women, 8 men). Respiratory muscle strength and respiratory functions were evaluated with specific devices. Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) parameters were measured for the muscle strength. Forced vital capacity (FVC), forced expiratory volume (FEV1), FEV1/FVC, peak expiratory flow, and forced expiratory flow (FEF25-75) parameters were measured for the respiratory functions. Questionnaire SF-36 was applied to evaluate health-related quality of life. A total of 24 MS patients' respiratory function test results were compared with healthy volunteers and significant changes were found at MIP, MEP, and FEV1 parameters. Quality of life was compared between the groups and there was a significant difference in parameters related with physical performance and physical-health-related role limitations. There is an early involvement of the respiratory muscles in patients with MS, yet clinical symptoms appear in later stages. Respiratory functions should be evaluated at the earlier stage of the disease so that rehabilitation can be planned in order to reduce respiratory complications and improve the quality of life in patients.

Jakość życia osób chorujących na stwardnienie rozsiane – przegląd literatury

Multiple sclerosis (MS) is a chronic progressive neurological disease with a characteristic myelin sheath loss and consequent progressive neurological disorders. The latest statistics, published by the Multiple Sclerosis International Federation, show that around the world people with MS are about 2.3 million, and most are from 20 to 40 years old. In Poland, it is estimated that 40-60,000 people suffer from multiple sclerosis. Until recently, people with MS were advised not to exercise. It was dictated that physical activity causes, among other things, an increase in body temperature, but this may contribute to the severity of the symptoms of the disease. However, lack of physical activity is conducive to lowering exercise tolerance and muscle weakness. Polish Society of Multiple Sclerosis promotes movement in patients with MS. Researchers point out that people with MS have lower levels of physical activity than in the general population, which aggravates motor impairment and negatively affects the quality of life of MS patients. The assessment of the quality of life of people with MS is largely influenced by both motor disability factors and socio-demographic or clinical factors. The disease negatively affects most areas of life, which contributes to a significant deterioration in its quality. It should be noted, however, that there is a greater tendency to deteriorate the quality of life in the physical dimension than in the mental one. The duration of SM does not affect the level quality of life, and with the duration of the disease, the disease is accepted by patients with MS. Elderly patients with progressive disease, less active and untreated, are significantly less likely to report quality of life than those younger, with a cast-off, lower EDSS score and treated. People who are more adept at ADL activities show higher quality of health in the social and social fields. Rehabilitation strategies, fatigue and sleep disorders, as well as cognitive functions, are analyzed in order to understand the underlying mechanisms and to identify the most effective therapeutic approaches. The study of the relationship between individual and clinical factors of people with multiple sclerosis with selected components of the quality of life can be used to model the patients’ illnesses and the course of the disease.

Determination of the levels of fatigue, pain, functional independence and quality of life in people with multiple sclerosis (MS) compared to non-MS individuals: use of standard psychometric tests on a small number of subjects

Aim: Using standard psychometric tests to determine the level of fatigue, pain, functional independence and quality of life in people with multiple sclerosis (MS) compared to non-MS people on a small number of subjects, and establish the correlation between fatigue and pain with perceived quality of life related to fatigue, pain, emotional and physical functioning. Patients and Methods: A group of people with MS (N = 17), predominantly female gender, 21-70 years old, EDSS (Expanded Disability Status Scale) values from 0.0 to 8.0 without relapse and corticosteroid therapy for the past 4 weeks and without severe chronic illnesses, was subjected to the following tests: Barthel Index, Functional Independence Measure, Visual Analogue Scale, Modified Fatigue Impact Scale and Medical Outcomes Study 36-Item Short-Form Health Survey. The control group (N = 17) without severe acute and chronic illnesses was also subjected to the same tests. Results: Statistically significant differences between the groups (P <0.05 - P <0.001) and statistically significant (P <0.05) correlation between fatigue level and perceived quality of life related to fatigue and the absence of link between pain level and perceived quality of life related to pain. The correlations between fatigue and pain level and the quality of life-related physical functioning has been statistically significant (P <0.05), unlike the correlation with the quality of life associated with emotional functioning. Conclusion: The selected combination of psychometric tests showed clear differences in the level of fatigue, pain, functional independence and quality of life in MS patients compared to non-MS people on a small number of subjects and established a correlation between fatigue level with perceived quality of life related to fatigue and also fatigue and pain levels with the quality of life associated with physical functioning.

Features of Coping with Disease in Iranian Multiple Sclerosis Patients: a Qualitative Study.

Introduction: Coping with disease is of the main components improving the quality of life in multiple sclerosis patients. Identifying the characteristics of this concept is based on the experiences of patients. Using qualitative research is essential to improve the quality of life. This study was conducted to explore the features of coping with the disease in patients with multiple sclerosis. Method: In this conventional content analysis study, eleven multiple sclerosis patients from Iran MS Society in Tehran (Iran) participated. Purposive sampling was used to select participants. Data were gathered using semi structured interviews. To analyze data, a conventional content analysis approach was used to identify meaning units and to make codes and categories. Results: Results showed that features of coping with disease in multiple sclerosis patients consists of (a) accepting the current situation, (b) maintenance and development of human interactions, (c) self-regulation and (d) self-efficacy. Each of these categories is composed of sub-categories and codes that showed the perception and experience of patients about the coping with disease. Conclusion: Accordingly, a unique set of features regarding features of coping with the disease were identified among the patients with multiple sclerosis. Therefore, working to ensure the emergence of, and subsequent reinforcement of these features in MS patients can be an important step in improving the adjustment and quality of their lives.

Health-related quality of life in multiple sclerosis patients with accompanying diseases

Introduction : Multiple sclerosis (MS) is a progressive demyelinating neurologic disease characterized by a different extent of comorbidity. Everydaily life is challenging for these patients because of physical and psychological impairments. The purpose of this study was to comparatively analyze the relationships between several health-related quality of life aspects of MS patients` in case of accompanying diseases. Material and methods : Health-related uality of life of 80 MS patients, 56 females and 24 males, at a mean age of 49 years, was examined by means of Short Form-36 questionnaire. Forty patients presented with at least one accompanying chronic disease. Results : These patients presented with similar Expanded Disability Status Scale scores of 2.0 or 2.5. Most questionnaire scores differed between MS patients without and with comorbidity. Usually, comorbidity additionally worsened patients` quality of life. There were statistically significant differences between the patients with MS alone and those with MS and comorbidity concerning the depression ( t =5.877; p<0.0001); the troubles with concentration/thinking ( t =4.822; p<0.0001); the troubles with memory ( t =4.020; p<0.0001); the feeling of fatigue ( t =4.148; p<0.0001), and the feeling of happiness ( t =-3.399; p<0.001). Conclusion : The hot topic of the health-related quality of life of the patients with MS and comorbidities necessitates further interdisciplinary research. Correct treatment and follow-up of MS patients and particularly of those with common accompanying cardiovascular and other neurological diseases could contribute to long-lasting preservation of acceptable individual quality of life.

Quality of life among multiple sclerosis patients in Saudi Arabia.

Objective:To assess quality of life in multiple sclerosis (MS) patients and determine the factors associated with levels of quality of life in MS patients in a public hospital in Saudi Arabia.Methods:A cross-sectional study was conducted from June 2016 to April 2017 in King Abdulaziz Medical City, Jeddah, Kingdom of Saudi Arabia. Multiple sclerosis patients attending the outpatient and inpatient services were approached and recruited to participate in the study. The Arabic version of EuroQOL-5 Dimensions instrument (EQ-5D) was utilized for the assessment of MS patients quality of life.Results:Data on quality of life were obtained from 292 patients. The reported quality of life of MS patients as measured by the EQ-5D index value score was 0.31±0.51 and the EQ-VAS score was 73.87±23.41, respectively. It was found that quality of life determined numerically in the EQ-5D index value and EQ-VAS deteriorates proportionally according to the disease duration.Conclusion:Multiple sclerosis is associated with a considerable effect on the patients quality of life. It continues to be challenging to manage both medically and psychosocially. Clinicians should consider the assessment of quality of life as routine practice along with the other important measures including symptomatic evaluation, laboratory tests, and neuroimaging to provide a holistic care of their MS patients.