Do people with multiple sclerosis receive appropriate support from the National Disability Insurance Scheme matching their level of disability? A description of disease 'burden and societal cost in people with multiple sclerosis in Australia
This study is the first to assess if the National Disability Insurance Scheme (NDIS) package allocated to people with multiple sclerosis (pwMS) is correlated with the disability level measured by standardised neurological assessment.MethodsWe aimed to recruit 10 pwMS per expanded disability status score (EDSS) step, including EDSS 0 (no disability) up to 9 (bedridden), and requested information about their NDIS application. Value of their packages was compared with mobility, cognition and psychological impact.ResultsOut of 186 pwMS, only 49% of all patients had an NDIS package approved. The mean values of the annual allowance were AU$30318 for patients with mild disability, AU$38361 for moderate disability and AU$115113 for severe disability. There was a striking variability in packages approved, but restricted mobility seems to be the driving factor. Rejection rates were
CONCLUSIONS: COVID-19 pandemic has given rise to barriers that affect almost every aspect of healthcare and rehabilitation in neurologically challenged populations prompting an increase in their disability level. This can assist policymakers in designing mitigation strategies to minimize the detrimental effects on this vulnerable population.Implications for rehabilitationPandemic has led to the worsening of existing motor and non-motor symptoms, which need to be monitored, assessed and managed medically, and through rehabilitation in neurologically challenged populations.Notable decline of cognition and physical activity i...
ConclusionsOur findings suggest that the type of occupation plays a role in the level and course of SA and DP among PwMS.Key messagesOver time SA and DP levels increased among PwMS regardless of type of occupation.PwMS in Managers or Science and Technology had less probability of belonging to the increasing trajectories.
Conclusion: This case series highlights the large variability of the course of COVID-19 in ocrelizumab-treated MS patients. The challenges encountered by the healthcare system in the early phase of the COVID-19 pandemic might have contributed to the case fatality ratio observed in this series. Higher MS-related disability was associated with a more severe COVID-19 course.
Conclusion: Despite the high rate of treatment switch, mainly due to the risk of PML, almost one in four who started on NTZ achieved NEDA-3 after 5 years, and the overall disease progression was low in the total cohort. Treating less advanced disease seems to predict better long-term stability.
ConclusionsIn contrast to references, employed and self-employed PwMS had similar probabilities of reaching over 180 days of SA.Key messagesThis study emphasizes that in Sweden also self-employed have access to sickness compensation, independently of employment status condition.Access to sickness compensation is utilized by PwMS.
ConclusionWe demonstrate that rim lesions are detectable in early-stage RRMS on 3 T MRI across multiple centres, although their relationship to lesion enlargement is equivocal in this small cohort. Identification of SWI rims was subjective. Agreed criteria for defining rim lesions and their further validation as a biomarker of chronic inflammation are required for translation o f SWI into routine MS clinical practice.
Discussion Our data illustrate that aging in MS is associated with a dysbalance between costimulatory and immunoregulatory signals provided by CD8 T cells favoring a proinflammatory phenotype and, more importantly, a pattern of premature immune aging in the CD8 T-cell compartment of young patients with MS with potential implications for disease severity.
Cerebellum. 2021 Oct 17. doi: 10.1007/s12311-021-01336-6. Online ahead of print.ABSTRACTAlthough Charcot characterized classic cerebellar symptoms in people with multiple sclerosis (PwMS) in 1877, the impact of cerebellar dysfunction on MS symptoms has predominately been evaluated in the last two decades. Recent studies have clearly demonstrated the association between cerebellar pathology, including atrophy and reduced fractional anisotropy in the peduncles, and motor impairments, such as reduced gait velocity and time to complete walking tasks. However, future studies using novel imaging techniques are needed to elucidat...
The new anti-CD20 monoclonal antibody showed significant improvement in the multiple sclerosis functional composite (MSFC) score, a measure of disability, compared with teriflunomide.Medscape Medical News
Multiple Sclerosis (MS) is a burdensome, chronic and autoimmune disease of the central nervous system. We aimed to report the incidence, prevalence, mortality, and Disability Adjusted Life Years (DALYs) of MS ...