How does multiple sclerosis affect sexual satisfaction in patients' spouses?

Background: Sexual dysfunction (SD) is a common complaint among multiple sclerosis (MS) patients with a significant impact on the quality of life (QoL) of afflicted couples. The purpose of this study was to determine sexual satisfaction (SS) in the spouses of MS patients and its impact on the QoL. Methods: A total of 214 spouses of MS patients were enrolled in this cross-sectional study. They completed the Larson Sexual Satisfaction Questionnaire and SF-8 Health Survey. Results: The mean ± SD age of the spouses was 39.8 ± 9.7 years, and the duration of MS was 5 years or less in most of their partners. The mean ± SD score of QoL was 71.0 ± 20.3 (out of 100), and the mean SS score was 89.2 ± 18.6 (out of 125), showing moderate satisfaction. The highest score was among male spouses younger than 40 years old. The SS scores were also lower among female spouses. In the final model, it was found that SD, psychiatric symptoms, cognitive impairment, and the level of disability of patients were independent explanatory factors for the SS of their spouses. Conclusion: The findings supported the role of SS in the QoL of spouses of MS patients. Therefore, the attention of physicians to this hidden aspect of the life of MS patients is crucial.

Multiple sclerosis and COVID-19: A retrospective study in Iran.

OBJECTIVES: Previous studies suggested a higher rate of COVID-19 infection in patients with multiple sclerosis than in the general population, and limited studies addressed the impact of COVID-19 and its vaccination in patients with multiple sclerosis in Iran. We decided to investigate the factors associated with COVID-19 infection, the effects and side effects of the COVID-19 vaccination in patients with multiple sclerosis (MS). METHODS: We used the data of the patients with multiple sclerosis registered in a referral clinic in Kerman, one of the large cities in Iran (a population of 537,000 inhabitants), to explore the association between demographic variables, the history of COVID-19 vaccination, and the clinical outcomes. RESULTS: Of the 367 participants in this study, 88.3% received the COVID-19 vaccine, 35.4% were confirmed COVID-19 cases, and the incidence of COVID-19 was much higher before vaccination (24.5% before vaccination versus 10.1% after vaccination). The multivariable logistic regression model showed that male gender (OR = 2.64, 95% confidence interval: 1.21, 5.74) and current employment (OR = 3.04, 95% confidence interval: 1.59, 5.80) were associated with an increased risk of COVID-19. The only factor associated with the adverse effects of COVID-19 vaccination was the type of vaccine (AstraZeneca). CONCLUSION: Our findings showed that the vaccination protected MS cases considerably against COVID-19. In addition, the side effects of the vaccines were not noticeably high in these cases as well. Among all COVID-19 vaccines, AstraZeneca had the most common side effects, so people must be aware of them before vaccination. The male gender and employment were the most important variables in the prevalence of COVID-19 in patients with multiple sclerosis in our study.

Role of Muscarinic Receptors in Hypoalgesia Induced by Crocin in Neuropathic Pain Rats.

OBJECTIVE: Crocin as an important constituent of saffron has antineuropathic pain properties; however, the exact mechanism of this effect is not known. The aim of this study was whether the hypoalgesic effect of crocin can be exerted through muscarinic receptors. MATERIALS AND METHODS: In the present project, 36 male Wistar rats (200 ± 20 g) were used. Animals randomly divided into six groups (sham, neuropathy, neuropathy + crocin, neuropathy + atropine 0.5 mg/kg, neuropathy + atropine 1 mg/kg, and neuropathy + atropine 1 mg/kg + crocin). Neuropathy was induced by the chronic constriction injury (CCI) method on the sciatic nerve. Crocin and atropine was administered intraperitoneally during 14 days following the 14th day after surgery. Pain response was detected every three days, two hours after each injection and 3 days following last injection. Mechanical allodynia and thermal hyperalgesia were detected using the Von Frey filaments and plantar test device, respectively. RESULTS: CCI significantly reduced the paw withdrawal response to mechanical and thermal stimulus (P < 0.01 and P < 0.05, respectively). Crocin therapy significantly reduced mechanical allodynia and thermal hyperalgesia induced by CCI (P < 0.05). Atropine pretreatment significantly blocked the hypoalgesic effect of crocin (P < 0.05 in mechanical allodynia and P < 0.01 in thermal hyperalgesia). Fourteen days administration of atropine alone at a dose of 0.5 mg/kg but not 1 mg/kg significantly reduced CCI-induced mechanical allodynia at day 30 after surgery. CONCLUSION: Crocin significantly decreased CCI-induced neuropathic pain. The hypoalgesic effect of crocin was blocked by atropine pretreatment, which indicates an important role for muscarinic receptors in the effect of crocin.

Role of Cannabinoid Receptors in Crocin-Induced Hypoalgesia in Neuropathic Pain in Rats.

PURPOSE: Neuropathic pain involves injury or alteration of the normal sensory and modulatory nervous systems to produce a set of symptoms that are often difficult to treat. Previous study indicates that crocin has anti-inflammatory properties that may be mediated by the neurotransmitter system. In this study, we determine if there is an interaction between crocin and the cannabinoid system on chronic constriction injury (CCI)-induced neuropathic pain in male rats. MATERIALS AND METHODS: In this experimental study, adult male Wistar rats (220-250 g) were used. CCI was induced by setting four loose ligatures around the sciatic nerve. In part 1, after nerve lesion, vehicle, crocin (60 mg/kg) or Win 55-212-2 (0.1 mg/kg) as an agonist and AM 251 (0.1 mg/kg) as an antagonist of cannabinoid receptors were injected intraperitoneally daily in separate groups for 2 weeks. In part 2, two weeks after nerve lesion, vehicle (5 µL), crocin (6 µg/5 µL), Win 55-212-2 (0.1 µg/5 µL), AM 251 (0.1 µg/5 µL) were administered intracerebroventricularly (ICV) in separate groups. Mechanical allodynia and thermal hyperalgesia were measured using Von Frey filaments and plantar test device, respectively, at day 14. Data were analyzed by two-way ANOVA and Sidak's multiple comparisons post-test. RESULTS: Results indicated that centrally administered crocin significantly decreased thermal hyperalgesia and mechanical allodynia. Also, peripheral injection of crocin significantly decreased mechanical allodynia but not thermal hyperalgesia. Central or peripheral administration of Win 55-212-2 or AM 251 modulates the analgesic effect of crocin significantly. CONCLUSION: Our findings showed that crocin has significant analgesic effects that are probably mediated by an endocannabinoid mechanism.

A New Method to Segment the Multiple Sclerosis Lesions on Brain Magnetic Resonance Images.

Automatic segmentation of multiple sclerosis (MS) lesions in brain magnetic resonance imaging (MRI) has been widely investigated in the recent years with the goal of helping MS diagnosis and patient follow-up. In this research work, Gaussian mixture model (GMM) has been used to segment the MS lesions in MRIs, including T1-weighted (T1-w), T2-w, and T2-fluid attenuation inversion recovery. Usually, GMM is optimized by using expectation-maximization (EM) algorithm. The drawbacks of this optimization method are, it does not converge to optimal maximum or minimum and furthermore, there are some voxels, which do not fit the GMM model and have to be rejected. So, GMM is time-consuming and not too much efficient. To overcome these limitations, in this research study, at the first step, GMM was applied to segment only T1-w images by using 100 various starting points when the maximum number of iterations was considered to be 50. Then segmentation results were used to calculate the parameters of the other two images. Furthermore, FAST-trimmed likelihood estimator algorithm was applied to determine which voxels should be rejected. The output result of the segmentation was classified in three classes; White and Gray matters, cerebrospinal fluid, and some rejected voxels which prone to be MS. In the next phase, MS lesions were detected by using some heuristic rules. This new method was applied on the brain MRIs of 25 patients from two hospitals. The automatic segmentation outputs were scored by two specialists and the results show that our method has the capability to segment the MS lesions with dice similarity coefficient score of 0.82. The results showed a better performance for the proposed approach, in comparison to those of previous works with less time-consuming.