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López-Armas GDC, Ramos-Márquez ME, Navarro-Meza M, Macías-Islas MÁ, Saldaña-Cruz AM, Zepeda-Moreno A, Siller-López F, Cruz-Ramos JA. Leukocyte Telomere Length Predicts Severe Disability in Relapsing-Remitting Multiple Sclerosis and Correlates with Mitochondrial DNA Copy Number. Int J Mol Sci 2023; 24:ijms24020916. [PMID: 36674427 PMCID: PMC9862686 DOI: 10.3390/ijms24020916] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/12/2022] [Accepted: 12/21/2022] [Indexed: 01/06/2023] Open
Abstract
Multiple sclerosis (MS) is a chronic autoimmune inflammatory disease that affects the nervous system. Peripheral blood leukocyte telomere length (LTL) and mitochondrial DNA copy number (mtDNA-CN) are potential biomarkers of neurological disability and neural damage. Our objective was to assess the LTL and mtDNA-CN in relapsing-remitting MS (RRMS). We included 10 healthy controls, 75 patients with RRMS, 50 of whom had an Expanded Disability Status Scale (EDSS) from 0 to 3 (mild to moderate disability), and 25 had an EDSS of 3.5 to 7 (severe disability). We use the Real-Time Polymerase Chain Reaction (qPCR) technique to quantify absolute LTL and absolute mtDNA-CN. ANOVA test show differences between healthy control vs. severe disability RRMS and mild-moderate RRMS vs. severe disability RRMS (p = 0.0130). LTL and mtDNA-CN showed a linear correlation in mild-moderate disability RRMS (r = 0.378, p = 0.007). Furthermore, we analyzed LTL between RRMS groups with a ROC curve, and LTL can predict severe disability (AUC = 0.702, p = 0.0018, cut-off < 3.0875 Kb, sensitivity = 75%, specificity = 62%), whereas the prediction is improved with a logistic regression model including LTL plus age (AUC = 0.762, p = 0.0001, sensitivity = 79.17%, specificity = 80%). These results show that LTL is a biomarker of disability in RRMS and is correlated with mtDNA-CN in mild-moderate RRMS patients.
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Affiliation(s)
- Gabriela del Carmen López-Armas
- Laboratorio de Biomédica-Mecatrónica, Subdirección de Investigación y Extensión, Centro de Enseñanza Técnica Industrial Plantel Colomos, Guadalajara 44638, Mexico
| | - Martha Eloisa Ramos-Márquez
- Departamento de Biología Molecular y Genómica, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Mónica Navarro-Meza
- Laboratorio C. de Neuronutrición y Memoria, Departamento de Promoción, Preservación y Desarrollo de la Salud, Centro Universitario del Sur, Universidad de Guadalajara, Ciudad Guzmán 49000, Mexico
| | - Miguel Ángel Macías-Islas
- Departamento de Neurociencias, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Ana Miriam Saldaña-Cruz
- Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Abraham Zepeda-Moreno
- Departamento de Clínicas de la Reproducción Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Fernando Siller-López
- Programa de Bacteriología, Facultad de Ciencias de la Salud, Universidad Católica de Manizales, Manizales 170002, Colombia
| | - José Alfonso Cruz-Ramos
- Departamento de Clínicas Médicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
- Coordinación de Investigación, Instituto Jalisciense de Cancerología, Guadalajara 44280, Mexico
- Correspondence:
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Cortese M, Bjornevik K, Chitnis T, Ascherio A, Munger KL. Aging with multiple sclerosis: A longitudinal study of physical function, mental health, and memory in two cohorts of US women. Mult Scler 2021; 28:121-131. [PMID: 33860717 DOI: 10.1177/13524585211007739] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND It is unknown how individuals with multiple sclerosis (MS) age compared to unaffected peers. OBJECTIVES The objective of the study is to describe the impact of MS on health and functioning in aging women. METHODS We used 10-item Physical Functioning Scale (PF10) scores (from the Short Form-36 (SF-36)) and other indicators of general, physical, mental health, and memory collected repeatedly over 25 years with self-administered questionnaires among participants in the Nurses' Health Study (n = 121,700 recruited at ages 30-55) and Nurses' Health Study II (n = 116,429 recruited at ages 25-42) to compare women with MS (n = 733) to unaffected peers in their health and disability, and describe/quantify the burden of aging with MS. RESULTS Women with MS had a consistently lower PF10 by 0.9-1.7 standard deviations with greater overall variability than unaffected women. PF10-scores gradually decreased with increasing age in both groups, but MS cases declined 3-4 times faster in midlife, while decline was similar in old age. The physical function score of 45-year-old women with MS was comparable to that of 75-year-old unaffected women; 70-year-old women with MS scored similarly to 85-year-old unaffected women. MS cases also reported worse health/more disability throughout adulthood on the other indicators. CONCLUSION The age-related decline in physical health is accelerated by 15-30 years in MS patients compared to unaffected peers.
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Affiliation(s)
- Marianna Cortese
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Kjetil Bjornevik
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Tanuja Chitnis
- Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Boston, MA, USA
| | - Alberto Ascherio
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA/Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA/Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Kassandra L Munger
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Silveira SL, Cederberg KLJ, Jeng B, Sikes EM, Sandroff BM, Jones CD, Motl RW. Symptom clusters and quality of life in persons with multiple sclerosis across the lifespan. Qual Life Res 2021; 30:1061-1071. [PMID: 33155152 PMCID: PMC8005422 DOI: 10.1007/s11136-020-02689-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 01/30/2023]
Abstract
PURPOSE To describe symptom clusters based on severity of co-occurring symptoms among adults with multiple sclerosis (MS) by age groups and to further examine symptom clusters as a correlate of quality of life (QOL) by age groups. METHODS This cross-sectional study enrolled persons with MS between 20 and 79 years of age who completed measures of fatigue, depression, anxiety, sleep quality, and QOL using the 36-Item Short Form Health Survey. Bivariate correlation and partial correlation analyses examined associations among symptoms, QOL, and MS characteristics. K-means cluster analyses determined symptom clusters among the full sample and pre-determined age groups (i.e., 20-39, 40-59, and 60-79). One-way ANOVAs examined differences in QOL among clusters for the overall sample and by age groups. RESULTS Among the overall sample of 205 participants, symptoms were significantly correlated with QOL and three distinct clusters were identified and differentiated by the magnitude of symptom experience (i.e., mild, moderate, and severe). Results were consistent among young and middle-aged adults; however, among older adults two severe sleep problem clusters were identified that were distinguished by moderate versus severe fatigue, depression, and anxiety. ANOVAs among the overall sample indicated that the three symptom clusters varied significantly for both physical component scores, F(2, 202) = 12.03, p < .001, η2 = .10, and mental component scores, F(2, 202) = 137.92, p < .001, η2 = .58; severe symptom cluster was associated with worse QOL. Patterns in the age subgroup ANOVAs were consistent. CONCLUSIONS Given the strong association between severity of symptom clusters and QOL, approaches for targeting co-occurring symptoms are critically needed.
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Affiliation(s)
- Stephanie L Silveira
- Department of Physical Therapy, University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL, 35209, USA.
| | - Katie L J Cederberg
- Department of Physical Therapy, University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL, 35209, USA
| | - Brenda Jeng
- Department of Physical Therapy, University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL, 35209, USA
| | - E Morghen Sikes
- Department of Occupational Therapy, Shenandoah University, Winchester, VA, USA
| | - Brian M Sandroff
- Department of Physical Therapy, University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL, 35209, USA
| | - Catherine D Jones
- Department of Physical Therapy, University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL, 35209, USA
| | - Robert W Motl
- Department of Physical Therapy, University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL, 35209, USA
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Abstract
Les facteurs de protection retrouvés chez des octogénaires atteints de sclérose en plaques (SP) vivant à domicile ont été comparés à ceux d'individus sans SP du même groupe d'âge et de personnes moins âgées atteintes de SP. Les données provenant des octogénaires atteints de SP (n = 23) et d'un groupe de répondants plus jeunes avec cette maladie (n = 61) ont été tirées d'une enquête canadienne sur le vieillissement avec SP. Les données des groupes avec SP ont été comparées aux statistiques nationales d'octogénaires de la population générale. Les octogénaires avec SP présentaient plus d'incapacités et une prévalence plus élevée de troubles de l'humeur, mais étaient physiquement plus actifs que la population d'octogénaires de l'enquête canadienne. Les octogénaires avec SP ont déclaré éprouver moins de stress et de fatigue que le groupe d'individus plus jeunes avec SP. Bien que la différence d'âge entre les deux groupes avec SP soit d'une dizaine d'années, ces groupes ont rapporté des niveaux similaires de soutien social, d'aisance financière, d'incapacité physique et de participation. Le maintien d'appuis solides (sociaux et financiers), d'une attitude positive, la pratique d'activité physique et la participation aux activités quotidiennes peuvent contribuer au vieillissement dans la collectivité chez les individus avec SP, malgré les défis amenés par cette maladie. We aimed to determine protective factors distinguishing octogenarians with multiple sclerosis (MS) living at home from others their age and younger people with MS. Data from MS octogenarians (n = 23) and a matched group of MS young-old respondents (n = 61) were extracted from a Canadian MS aging survey. The MS groups were compared, along with a group of octogenarians from the general population, using national statistics. MS octogenarians lived with greater disability and higher prevalence of mood disorders but were more physically active than Canadian octogenarians without MS. MS octogenarians reported less stress and fatigue than the MS young-old group, and despite being more than a decade older, they reported similar levels of social support, financial flexibility, physical disability, and participation. Even when challenged by MS, maintenance of strong supports (social and financial), positive attitude, and participation in physical activity and life roles may contribute to aging in place.
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Bichuetti DB, Franco CA, Elias I, Mendonça ACR, Carvalho LFD, Diniz DS, Tur C, Tintoré M, Oliveira EMLD. Multiple sclerosis risk perception and acceptance for Brazilian patients. ARQUIVOS DE NEURO-PSIQUIATRIA 2018; 76:6-12. [PMID: 29364388 DOI: 10.1590/0004-282x20170167] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Accepted: 09/14/2017] [Indexed: 01/22/2023]
Abstract
The perception of multiple sclerosis (MS) severity and risk associated with therapies might influence shared decision making in different countries. We investigated the perception of MS severity and factors associated with risk acceptance in Brazil in 96 patients with relapsing-remitting MS using a standardized questionnaire and compared this with two European cohorts. Multiple sclerosis was perceived as a very severe disease and the risk of developing progressive multifocal leukoencephalopathy due to natalizumab was seen as moderate to high. Seventy-six percent considered a risk of 1:1,000, or higher, an impediment for natalizumab use. Older age was the only variable associated with higher risk acceptance and our patients showed a more conservative profile than German and Spanish patients. Our patients perceived MS severity and progressive multifocal leukoencephalopathy risk similarly to elsewhere, but their willingness to take risks was more conservative. This should be considered when discussing therapeutic options and it might have an impact on guideline adaptations.
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Affiliation(s)
| | - Carolina Azze Franco
- Universidade Federal de São Paulo, Disciplina de Neurologia, São Paulo SP, Brasil
| | - Isaac Elias
- Universidade Federal de São Paulo, Disciplina de Neurologia, São Paulo SP, Brasil
| | - Andreia C R Mendonça
- Universidade Federal de Goiás, Faculdade Estácio de Sá de Goiás,Centro de Referência e Investigação em Esclerose Múltipla, Goiânia GO, Brasil
| | - Lorraine Fiama Diniz Carvalho
- Universidade Federal de Goiás, Faculdade Estácio de Sá de Goiás,Centro de Referência e Investigação em Esclerose Múltipla, Goiânia GO, Brasil
| | - Denise Sisterolli Diniz
- Universidade Federal de Goiás,Centro de Referência e Investigação em Esclerose Múltipla, Goiânia GO, Brasil
| | - Carmen Tur
- Universitat Autònoma de Barcelona, Hospital Universitari Valld'Hebron, Centre of Catalonia, Department of Neurology-Neuroimmunology and Multiple Sclerosis, Barcelona Spain.,University College London, Institute of Neurology, Department of Neuroinflammation, London, United Kingdom
| | - Mar Tintoré
- Universitat Autònoma de Barcelona, Hospital Universitari Valld'Hebron, Centre of Catalonia, Department of Neurology-Neuroimmunology and Multiple Sclerosis, Barcelona Spain
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Roth AK, Denney DR, Burns JM, Lynch SG. Cognition in older patients with multiple sclerosis compared to patients with amnestic mild cognitive impairment and healthy older adults. Neuropsychology 2018; 32:654-663. [PMID: 29939057 PMCID: PMC6126957 DOI: 10.1037/neu0000453] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Progress in the treatment of multiple sclerosis (MS) has resulted in larger numbers of patients living to an advanced age, but little is known about the cognitive status of these individuals. The primary purpose of this study was to identify differences in the cognitive performance between elderly individuals with MS and those with amnestic mild cognitive impairment (aMCI). METHOD Three groups ranging in age from 60 to 80 were compared: patients with MS (n = 64), patients with aMCI (n = 58), and healthy adults (n = 70). All participants completed a standard neuropsychological test battery that evaluated domains of attention, processing speed, executive function, memory, language, and visual spatial function. RESULTS Compared to age- and gender-matched healthy controls, elderly MS patients exhibited a pattern of cognitive impairment centering on information processing speed and memory that was consistent with the deficits observed in other studies of MS patients regardless of age. Compared to aMCI patients, the MS patients exhibited worse performance on measures of processing speed, but better performance on a measure of memory under cued conditions (Selective Reminding Test), a nonspeeded measure of language (Boston Naming Test), and measures of executive function with processing speed statistically controlled (Trail Making Test, Stroop Test). CONCLUSIONS Differences on neuropsychological measures can serve to distinguish aMCI from MS-related cognitive impairment in older patients, but it is essential that these measures control for the deficit in processing speed that is such a primary feature of MS. (PsycINFO Database Record
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Affiliation(s)
| | | | - Jeffrey M Burns
- Department of Neurology, University of Kansas Medical Center
| | - Sharon G Lynch
- Department of Neurology, University of Kansas Medical Center
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Sebastião E, McAuley E, Shigematsu R, Motl RW. Feasibility study design and methods for a home-based, square-stepping exercise program among older adults with multiple sclerosis: The SSE-MS project. Contemp Clin Trials Commun 2017; 7:200-207. [PMID: 29696187 PMCID: PMC5898480 DOI: 10.1016/j.conctc.2017.07.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 05/22/2017] [Accepted: 07/26/2017] [Indexed: 10/31/2022] Open
Abstract
We propose a randomized controlled trial (RCT) examining the feasibility of square-stepping exercise (SSE) delivered as a home-based program for older adults with multiple sclerosis (MS). We will assess feasibility in the four domains of process, resources, management and scientific outcomes. The trial will recruit older adults (aged 60 years and older) with mild-to-moderate MS-related disability who will be randomized into intervention or attention control conditions. Participants will complete assessments before and after completion of the conditions delivered over a 12-week period. Participants in the intervention group will have biweekly meetings with an exercise trainer in the Exercise Neuroscience Research Laboratory and receive verbal and visual instruction on step patterns for the SSE program. Participants will receive a mat for home-based practice of the step patterns, an instruction manual, and a logbook and pedometer for monitoring compliance. Compliance will be further monitored through weekly scheduled Skype calls. This feasibility study will inform future phase II and III RCTs that determine the actual efficacy and effectiveness of a home-based exercise program for older adults with MS.
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Affiliation(s)
- Emerson Sebastião
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, United States
| | - Edward McAuley
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, United States
| | | | - Robert W Motl
- Department of Physical Therapy, University of Alabama at Birmingham, United States
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