b'Medicine & Researchdisability progression, or new MRI lesions), symptoms that worsen with heat or exertion.then they are transitioned to a more eective One of the earliest descriptions of thistherapy that may also have more risk as well. phenomenon was by an ophthalmologist, Dr.An alternative approach is referred to as Utho, more than a hundred years ago. Dr.induction therapy. Here, a more aggressive Utho found that MS could be diagnosed inoption, such as natalizumab, ocrelizumab, or some by documenting a worsening of visionalemtuzumab, is chosen as a rst-line therapy. whenthepatientwasputinahotbath.These options may have more risk but may Axons (nerve fibers) send electricalalsooerabetterchanceofpreventinga informationtoandfromthebrainviatransition to secondary progressive MS.myelinated nerve bers in the spinal cord andNew study suggests 4-aminopyridine helps cranial nerves. Demyelinated nerve bers inwith attention, executive functions a person with MS have a harder time doingso and may develop an electrical blockageA new study evaluated the eectiveness with exertion or heat exposure. Manipulationon cognitive performance and safety of 4- ofpotassiumchannelswithdrugslike4-aminopyridine administered to patients with aminopyridine(4-AP)mayhelpheat/relapsing-remitting multiple sclerosis. 4- exertional symptoms. It should be noted thataminopyridine was found to be an eective dalfampridine (Ampyra) is very similar to 4-AP.treatment on cognitive functions in patients Typically, we think of 4-AP/dalfampridinewith MS. The ndings were published in the ashelpingwithphysicalsymptoms,likejournal Multiple Sclerosis and Related Disorders. walking. This study showed that 4-AP couldDr. Thrower:Oneofthemorecommon also potentially help with cognition. 4-AP is notsymptoms seen in people with MS is called an FDA-approved drug but can be prescribednerve ber fatigue. Nerve ber fatigue is the andthenpreparedthroughcompoundingphysiological explanation behind many pharmacists.msfocusmagazine.org 60'