Continuing Clinical Research During Shelter‐in‐Place

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/162767/2/ana25840_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/162767/1/ana25840.pd

Key Components of Qigong for People With Multiple Sclerosis: A Survey of Clinicians, Researchers, and Instructors.

BACKGROUND: Preliminary evidence suggests that Qigong (QG), a mind-body therapy, may help address symptoms of multiple sclerosis (MS), but the heterogeneity of QG content and delivery may affect its feasibility, acceptability, and efficacy. OBJECTIVE: To survey researchers, clinicians, and QG instructors with experience working with people with MS to identify key components of MS-specific QG guidelines and protocols. METHODS: We conducted an online survey to identify QG forms and movements considered helpful for MS, reasons for selection, characteristics of effective learning environments, and recommended dosage and frequency of practice. Quantitative data were analyzed using summary statistics. Qualitative data were analyzed using reflexive thematic analysis. RESULTS: Forty-seven experts, including QG instructors, clinicians, and QG and MS researchers, completed the survey. Respondents had a mean (SD) of 20 (11) years of QG teaching experience, 26 (12) years of clinical practice, 24 (9) years of QG research experience, 13 (5) years of MS research experience, and worked with at least 3 (2) people with MS. Approximately 125 QG forms/movements were recommended. Some forms were specifically recommended to address MS symptoms (e.g., emotional regulation, balance and coordination, muscle strength and flexibility, immune regulation, and circulation). Some respondents felt that any QG form could be beneficial if basic principles were met (e.g., intentional movement, posture, focused awareness, rhythmic breathing/movement, and a relaxed mind and body). Instructor qualities included the ability to convey information clearly, being caring and compassionate, proficient in QG, and having basic knowledge of MS. To promote confidence in learning QG, recommendations included having simple, easy-to-learn movements with modifications based on physical ability. We provide a sample protocol based on these recommendations. CONCLUSIONS: This study provides expert guidance for developing a QG protocol for an MS population, including content and delivery recommendations

Oligoclonal Bands in Multiple System Atrophy: Case Report and Proposed Mechanisms of Immunogenicity

Multiple System Atrophy (MSA) is a neurodegenerative disease with heterogeneous manifestations and is therefore difficult to diagnose definitively. Because of this, oftentimes an extensive workup for mimickers is undertaken. We herein report a case where the history and cerebrospinal fluid (CSF) findings of oligoclonal bands suggested an inflammatory disorder. Immunomodulatory therapy failed to ameliorate symptoms or alter the trajectory of continued physical decline, prompting re-visitation of the diagnosis. Oligoclonal bands, while generally viewed as specific to multiple sclerosis or other inflammatory conditions, may be seen in other disease processes. Therefore, this finding should not exclude consideration of neurodegenerative disease.</jats:p

Case Report GABA B Encephalitis: A Fifty-Two-Year-Old Man with Seizures, Dysautonomia, and Acute Heart Failure

Autoantibodies to the -aminobutyric acid receptor, subtype B (GABA B ), are a known cause of limbic encephalitis. The spectrum of clinical manifestations attributable to this antibody is not well defined at the present time. Here we present a case of GABA B encephalitis presenting with encephalopathy, status epilepticus, dysautonomia, and acute heart failure. To our knowledge, heart failure and dysautonomia have not yet been reported with this syndrome

Enlarged perivascular spaces are not associated with vascular co-morbidities, clinical outcomes, and brain volumes in people with secondary progressive multiple sclerosis

Background In secondary progressive multiple sclerosis (SPMS) significance of enlarged perivascular spaces (ePVS) is unknown. Objectives, Methods: Analysis of associations between vascular co-morbidities, clinical outcomes, and volumetrics with categorical ePVS scores in midbrain, basal ganglia (BG), and centrum semiovale (CSO) in SPMS(n-46). Results, Conclusion: In BG, advancing age (Z = 2.68) and lower Expanded Disability Status Scale (Z = −2.04) were associated with increasing ePVS score. In CSO, advancing age (Z = 2.66) and male gender (Z = 2.45) were associated with increasing ePVS score. No associations between ePVS score and vascular co-morbidities or volumetrics existed; ePVS may not be an informative marker for SPMS. </jats:sec