~ Pain is useful to the extent that it motivates us to modify our behaviors in order to reduce whatever insult is causing the pain, because invariably that insult is damaging our tissues. Pain is useless and debilitating, however, when it is telling us that there is something dreadfully wrong that we can do nothing about. ~
Robert M. Sapolsky, Why Zebras Don’t Get Ulcers


Fatigue in multiple sclerosis could be pinpointed to brain region

Fatigue, though probably the most prevalent symptom of multiple sclerosis, is still a bit of a mystery to researchers and scientists. I know I have blind spots because I have lesions in my optic nerves, but there is no lesion in the MRI that the neurologist can point out and say, “This lesion here is the reason why you’re so always so tired.”

I’ve seen fatigue described in many ways and I’ve read different explanations for it. One of them has to do with inflammation. We know inflammatory processes in the body cause fatigue because they mobilize your defenses in order to stop them. Another explanation has to do with the lesions themselves. Every time there’s a message to carry and the road is blocked, your nerve cells find a way to go around it, taking a detour. That obviously uses up more energy and resources.

Now a recent study suggests that fatigue in multiple sclerosis may be connected to a specific region in the brain. Much like a stable person can suddenly develop mood disorders if they have lesions in brain regions that regulate mood, these findings hint that “Damage to strategic brain white matter and grey matter regions, in terms of microstructural abnormalities and atrophy, contributes to pathogenesis of fatigue in MS, whereas global lesional, white matter, and grey matter damage does not seem to have a role.”

If this turns out to be right, maybe, just maybe, we can hope that more studies will follow and we get more effective treatments? Pretty please?

Triggers, genes vs environment, and haunting thoughts on childhood

Last night a conversation started on Twitter about the triggers of multiple sclerosis and the question if an unhappy and stressful childhood could have messed up the immune system. I mentioned I lived my childhood with chronic stress and that has been proved to influence the immune system. When I woke up today a lot of people had stepped in with different opinions. Some of them acknowledged they had difficult family backgrounds, someone noted that while having had an unhappy childhood their brothers and sisters were fine, someone blamed it on a bacterial infection and some people mentioned genes were the only factor involved.

I believe that somehow all these are connected. Genes play a part. They carry the information that determines which conditions you’re more likely to develop. They’re probably the reason some people develop multiple sclerosis, while others develop rheumatoid arthritis, ALS, etc. However, they can’t be the only reason. And now I’m going to quote Robert M. Sapolsky on this article because he explains it a lot better than I do. Robert M. Sapolsky wrote one of my favorite books on stress, Why Zebras Don’t Get Ulcers, and here he discusses the role of genes:

Each of our 20,000 or so genes specifies the construction of a specific protein; proteins shape the structure and function of cells, the communication between them, and their collectivity as organisms. Scientists once thought that, starting at the beginning of a chromosome, there’d be a stretch of DNA coding for gene A, which directed the construction of protein A. Immediately after that would be the DNA coding for gene B, specifying for protein B, followed by gene C, and so on.

But this turned out to be wrong. Between the stretches of DNA coding for two genes came a stretch of ‘non-coding’ DNA, once pejoratively called ‘junk DNA’, of no obvious use. Then came the astonishing discovery that approximately 95 per cent of DNA is non-coding. It can’t be that nearly all of DNA is junk; instead, much of that 95 per cent is the instruction manual for using genes. More specifically, these ‘regulatory elements’ are the on-off switches determining when and how much a particular gene is transcribed (ie, prodded into instigating the construction of its protein). Just before the start of the DNA coding for a gene is a stretch of regulatory DNA constituting that gene’s ‘promoter’. If a particular ‘transcription factor’ comes floating over from somewhere in the cell and binds to that promoter, this triggers transcription of that gene.

So what could trigger these “transcription factors”? The answer is the environment. And environment can mean a lot of different things. That’s when lifestyle, infections, stress, emotions, etc., come in. In other words, you can have the genes that predispose you to develop multiple sclerosis, but without the right triggers you have a chance of never developing it. If it wasn’t the case, twins would suffer from the same conditions, and we know that’s not always true.

Drifting a little away from the genes topic, but still reflecting on the Twitter conversation, I started wondering about some things. While I don’t consider I had an unhappy childhood, I do know I come from a dysfunctional background. My parents divorced when I was 2 and my father didn’t care much and was always very absent. My mother was always too busy dealing with way too much she could handle on her own and didn’t pay much attention either. Except when I was sick. I remember when I was in hospital at 5 my father came to visit every day and brought me presents. My mother had to stop everything and take care of me whenever I had asthma attacks. So I wonder if I unconsciously learned in my childhood that being ill was the only way for people to pay attention to me and care for me…


Epstein-Barr Virus Connection to MS

I had mononucleosis when I was 18, during my freshman year in college. For two weeks, I had sore throat, temperature, and the lymph nodes in my neck were swollen. The blood tests confirmed it was indeed mono, and for several months after my initial symptoms the antibody count remained high, suggesting my body was still fighting the infection.

I never gave it much thought, although I remember two or three years later, still in college, telling a friend of mine that I felt my energy levels never went back to normal after that. It’s like the fatigue that comes with mono never left me, and it’s still with me today.

When I was diagnosed with ms and started reading about it, the connection with the Epstein-Barr virus came up, and I felt that it made sense, at least considering my history. It’s not that everyone infected with the virus will develop ms, but being infected with it under certain circumstances (i. e., as an adult) and combined with other variables (genetic predisposition, chronic stress, etc) may produce such outcome.

Recent research has been shedding even more light on this connection.  A 2012 study proves “the virus is involved in a manner more sophisticated and subtle than previously imagined, and may offer new ways to treat or prevent the disease.”

Even more recently a new study pointed out that ms relapses occur when the Epstein-Barr virus is active.

More interestingly, scientists came up with the hypothesis that ms could be caused by a retrovirus. Retroviruses are remnants of viral infections caught by our ancestors that are passed on through our genes. They are called “fossil viruses” and up until recently they were thought to be harmless. However, research has revealed some retroviruses may play a role in several autoimmune diseases.

Based on these pieces of evidence, scientists are looking at new and promising treatments for multiple sclerosis and other disabling conditions. So who knows what possible future therapies may be in store for us?

Links to the articles:

You’re Looking in The Wrong Place

gray-matterWhat if multiple sclerosis isn’t a disease of the brain’s white matter and rather originates in the gray matter? Scientists at Rutgers University in Newark tried a new approach to look into the gray matter of MS patients and what they found “suggests there are issues happening extremely early in the gray matter that precede myelin loss,” says co-investigator Patricia Coyle, a neurologist at Stony Brook University, S.U.N.Y. Read more.

“D” essential vitamin

You-are-my-sunshine-4-e1342543268970I saw one of my neurologists today for a routine appointment and for the first time I was prescribed vitamin D supplements. I already take them because I’ve been reading about their benefits ever since I was diagnosed, but this was the first time I had a doctor acknowledge how “the sunshine vitamin” is indeed important and not some kind of conspiracy theory. I guess doctors have been catching up on the latest research.

Read more here:
and here

Cure for insomnia








The first time I remember waking up after a couple of hours of sleep and not being able to fall asleep again I must have been around 15. It’s possible though that my sleep issues started earlier, as I remember always being a light sleeper and always having agitated nights. 

Nowadays, when I think about insomnia I think about it as a chronic illness, as much as I think about multiple sclerosis and endometriosis. Because since I was since 15 I’ve tried everything you can possibly imagine to be able to sleep well. That included diet changes, meditation, yoga, exercise, not having anything in my bedroom except things associated with rest… you name it. The only thing that seems to work is medication. Unfortunately I need to be permanently medicated for insomnia because, as research suggests, my sleepless nights may have had a negative contribution to the development of my ms.

So, if anyone has suffered from insomnia like me and has found ways to manage it other than being medicated, I’d love to hear your comments. In the meantime I’ll leave you with Alfred Hitchcock’s insights about insomnia. 😉

The Brain Does Repair Itself








I’ve never been very excited about stem cells therapy for two reasons: one is that it is still going to take decades before treatments based on stem cells are available, the second is because if you don’t find the causes to brain damaging diseases you can spend the rest of your life trying to repair your brain with stem cells that your body is still going to attack whatever it is it’s attacking, whether it’s myelin or other substance.

That being said, I still found this TED Talk interesting. Doctor Siddharthan Chandran explains that, contrary to what was believed some time ago, the brain does have the ability to repair itself, it just doesn’t do it well enough, or fast enough. So what can be done to help the body regenerate and what kind of therapies can we expect in the future?