b"Medicine & Research Doctors NotesThe MS News column includes analysis from Ben Thrower, M.D., MS Focus senior medical advisor. He draws from the top news stories of the quarter and explains what the news means to you, the person with MS. Christine Willis, MLIS, AHIP, is the Clinical Information Librarian at Children's Healthcare of Atlanta, Egleston Hospital. Relapse may have prior warning periodwarning period of cognitive decline in the Researchers in Sweden explored the30 days prior to the actual relapse.relationship between MS relapses andThose on B-cell DMTs lack antibody information processing speed among 3,877response to COVID-19 vaccination people with relapsing-remitting MS. ThisIn this observational cross-sectional study cohort study took place between 2001-2019in Switzerland, people with MS were treated using the Swedish MS registry. The symbolwith either rituximab or ocrelizumab. Evidence digit modalities scores were used to comparehas shown that people with MS who are processing speeds before and after relapses.treated with disease-modifying drugs that Relapses were categorized into 90 daystarget B-cells have an impaired humoral prerelapse and two years postrelapse. Theresponse to mRNA vaccines. In this study, research showed that acute inammation,49 patients had blood drawn four weeks after as measured by clinical relapse, can lead toreceiving the second dose of the SARS-CoV-2 transitory changes in cognition as well. Changes were recorded one month prior tovaccine to evaluate the IgG response against relapse and reduction in SDMT lasted one- the spike protein. The researchers found that and-a-half years. The article was publishedvaccination based on the onset of B-cell in the Annals of Neurology.reconstitution, instead of adherence to a time Dr. ThrowerThere are many facets of MSwindow, could be a way forward. One study that are not always obvious at the surface. MSlimitation noted is the small sample size and has been compared to an iceberg, with muchthe lack of data on T-cell responses. The ndings of it lying hidden. This applies to symptomswere published in the journal Vaccines. such as fatigue, cognitive dysfunction, and pain,Dr. ThrowerAs we enter the third year of the which are not always obvious to the casualCOVID-19 pandemic, we are all hoping that observer but can have dramatic effects onthe end will come soon. In the meantime, the quality of life. Relapses are a hallmark of theMS community has had to think about what most common form of MS, relapsing-remitting.COVID-19 means to them. Vaccinations have A relapse is dened as a new or worseningbeen our most effective weapon in this neurological symptom lasting at least 24pandemic, but some MS therapies could make hours and with no better explanation. Thisthat weapon less effective. B-cell therapies study would suggest that MS relapses may be(Ocrevus, Rituxan, Kesimpta, and Truxima) morethanthat.Itappearsthatthereisawork by depleting a population of B-cells 53msfocusmagazine.org"