Week 5 - MS Flashcards
What pathologies cause MS?
Inflammatory and Neurogenerative
MS is a complex _____-____ based progressive _________ ______.
Auto-immune
Neurological disorder
What kind of white blood cells help immune functioning?
B cells
T cells
What are B cells?
White blood cells that help immune function
- develop in bone marrow
- produce antibodies that ambush foreign antigens in bloodstream
What are T cells?
White blood cells that help immune function
- Develop in thymus gland (near lungs)
- direct attacks of foreign substances such as bacteria, viruses or foreign tissues (cancerous cells)
- Augment B cell response
- Produce substances called cytokines that direct responses and activities in other immune cells
Where do T cells develop?
Thymus gland (near lungs)
What are the visual symptoms of MS?
Nystagmus
Optic neuritis
Diplopia
What are some central symptoms of MS?
Fatigue
Cognitive impairment
Depression
Unstable mood
What are some symptoms of speech/throat associated with MS?
Dysarthria
What are some musculoskeletal symptoms of MS?
Weakness
Spasms
Ataxia
What are some sensation symptoms of MS?
Pain
Hypothesias
Paraethesias
What are some bowel symptoms of MS?
Incontinence
Diarrhea or constipation
What are some urinary symptoms of MS?
Incontinence
Frequency or retention
What is the age of onset for MS?
Late 20s/early 30s
What gender is more prone to MS?
Females
How many people worldwide have MS?
2.5mil
How many people in Australia currently have MS?
24,000
What are the 4 types of MS?
Relapsing-remitting
Primary progressive
Secondary progressive
Progressive-relapsing
What is relapsing-remitting MS?
Unpredictable attacks which may or may not leave permanent deficits followed by periods of remission
What is primary progressive MS?
Steady increase in disability without attacks
What is secondary progressive MS?
Initial relapsing-remitting MS that suddenly begins to have decline without periods of remission
What is progressive-relapsing MS?
Steady decline since onset with superimposed attacks
What is often considered an ‘invisible symptom’ of MS?
Cognitive impairment
How many people with MS in Australia have cognitive impairments?
58%
What cognitive areas are most affected by MS?
Processing speed
Complex attention
New learning and memory
Prospective memory
Executive functions
Social cognition
What cognitive areas are least affected by MS?
General knowledge
Intelligence
Basic attention and orientation
Language
Immediate recognition memory
Implicit memory
why is a lack processing speed a hallmark feature of MS?
Myelin loss
Slowed neuron/nerve conduction
Invisible damage to neurons/nerves
What is affected by slow processing speed?
Higher-order cognition (eg. executive functioning, memory)
What tests may be used to assess processing speed?
Symbol digit Modality test
How is complex attention affected by MS?
Working memory
Divided attention (eg. switching between tasks, do one task and forget about the other)
Sustained attention
How does MS affect long-term memory?
One of the most reported symptoms
Forgetting what someone tells you
Having a thought but then forgetting it quickly
Learning difficulties rather than retrieval
prospective memory
What undermines a persons memory with MS?
Slow processing speed
Susceptibility to interference
Executive difficulties
visual difficulties
How does MS affect visualspatial abilities?
Visual disturbances due to optic nerves (optic neuritis)
Can result in difficulties with:
Organising visual info
seeing relationships between objects
Proprioception
How does MS affect executive abilities?
Disorganisation
Difficulty sequencing/planning
Problem solving difficulties
Lack flexibility
Lack ability to maintain focus with distractors
What undermines executive function for people with MS?
Slow processing speed
How does the pseudobular affect, affect social cognitions?
Uncontrollable laughing/crying
More intense/ out of context
How does MS affect social cognitions such as emotion recognition?
Impaired on fear and anger
How can we measure a person’s theory of mind?
Mind in the Eyes Task
TASIT - measures sarcasm
What social cognitions are affected by MS?
Pseudobular affect
Emotion recognition
Theory of mind
Emotional lability
Inappropriate behaviour eg. sexual disinhibition
How is MS dementia different from AD?
Basic language intact in MS relative to AD
Complex attention impaired more than AD in early phases
Memory problems different in MS - due to retrieval or initial acquisition in MS rather than storage/retention in AD
Orientation to place/person rarely affected in MS
What are some treatments for MS relapses?
Corticosteroids
Plasma exchange
What are the three types of disease modifying therapies or DMTs?
Immunosuppressants
Immunomodulators
Immune constitution therapy
What are the six stages of stem cell therapy?
- Stem cells moved from bone marrow to blood stream using chemotherapy and synthetic growth factor
- Machine collects blood and separates out stem cells
- Stem cells frozen ready to return to body later
- More chemotherapy used to fully or partially wipe out bone marrow and immune system
- Stem cells returned tp body using a drip
- Body recovers over a period of 3-6 months or longer
How may you improve memory in people living with MS?
Use techniques to increase chances of encoding/storing information
How may you improve executive abilities in those with MS?
Break things down into manageable steps
Take time to plan ahead and diarise
For big decisions, take time to list alternatives
Ask for help with more difficult tasks
How can you lower fatigue symptoms of MS?
Take regular breaks
Do important tasks when most alert
CBT - change perceptions of management
How can sleep quality improve cognition?
Better sleep = better memory and executive functioning
How can exercise improve cognition?
Improves verbal memory
Increases cardio-respiratory fitness
Lowers inhibitory errors
