Researchers at UW Medicine recently published two studies showing that patients with multiple sclerosis should be given non-pharmaceutical help by a doctor at the time of diagnosis for pain, fatigue, depression or anxiety, rather than waiting.
The first study, published in the April 2022 edition of the Journal of Multiple Sclerosis, found that clinically-significant levels of pain, fatigue, and depression, as well as anxiety, were more common in newly diagnosed patients. The findings also suggest that prompt investigation is needed if quality of life is to be maintained and optimized.
Kevin Alschuler, lead researcher on the National MS Society-funded research study, said the symptoms, pain, fatigue, depression and anxiety were found at the diagnosis stage. Ulcer instructions for psychiatric services at UW Medicine’s Multiple Sclerosis Center.
The study found that 60% of patients experienced fatigue; In the first year of diagnosis, 50% experienced pain and 47% experienced depression, while 39% experienced anxiety.
He said, “We want to fix this immediately instead of going off the road for 5 or 10 years.”
According to the National Multiple Sclerosis Society, more than 1 million people in the United States live with MS. Most people live in cold weather like the Northwest. The disease, for which there is no known cure or exact cause, acts as something that stimulates the body’s immune system to attack the brain and spinal cord. The resulting damage to myelin – the protective layer around the nerves – disrupts signals to and from the brain. This can result in numbness, memory problems, pain, fatigue or paralysis.
The study, as well as a companion study published in the May print edition of the Journal of Neurology, followed similar patients in the first year after diagnosis – mostly whites and women. In total, the study followed 230 patients. From 2014 to 2018, patients were recruited from the UW Medicine Multiple Sclerosis Center and the MS Center of the Swedish Neuroscience Institute.
The second study looked at patients’ quality of life immediately after diagnosis, two months, three months, six months, nine months, and then one year later. The results of the study showed that, on average, quality of life remained largely stable throughout the year, a finding that surprised researchers.
“Patients newly diagnosed face emotional consequences of the diagnosis, as well as numerous tests and treatment decisions,” noted Alsular, the study’s lead author.
“The results showed that, on average, if they came in and were doing well in diagnosis, they had a tendency to stay that way for the first year,” Alsular said. “If they were stumbling, it was their tendency to stay that way.”
Alschuler and his colleague Don Ehde are both interested in early non-drug interventions for the common symptoms experienced by MS patients. Ehde is a Clinical Psychologist and holds the Nancy and Buster Alward Endowed Professorship in MS Research in the Department of Rehabilitation Medicine at the UW School of Medicine.
Most of the time, the patient was dealing with symptoms for many years before the formal diagnosis, both noted.
“Through self-management of symptoms, including cognitive behavioral therapy, we help patients become competent, especially in areas of fatigue and pain, with coping skills,” said Ehde, who co-authored a quality of life study published this month. Along with Alschuler, she has published studies over the years showing the effectiveness of such interventions in people with MS. Ehde was one of the leading authors of the April study. Who looked at the path of symptoms a year after the diagnosis of MS.
She said, “We teach them how to use strategies like relaxation or mindfulness meditation techniques as well as how to reduce fatigue and manage stress better. “Patients who learn these skills often find that not only does their pain and fatigue decrease, but they can do more of what is important to them despite having MS.”
The team’s next step is to find options for early intervention to help newly diagnosed patients. Along these lines, Alschular has worked with co-founder Evan Molton, another clinical psychologist, to develop interventions to help newly diagnosed patients cope with the uncertainty of living with MS. Their 2019 experimental study looked at the effects of promoting tolerance for uncertainty to improve quality of life and reduce anxiety. They followed this up with a large clinical trial that recently completed data collection, Alsular said. The results of this study are expected later this year.