A Case of Cerebral Amyloid Angiopathy Related Inflammation After Vaccination Against SARS-CoV-2

Background Cerebral amyloid angiopathy related inflammation (CAA-RI) is a neuroinflammatory disease that is associated with perivascular amyloid- deposition. Case Presentation A middle-aged woman with a remote history of autoimmune disorders presented with unilateral migraine headaches, dizziness, unsteadiness, and fogginess 36 hours after administration of mRNA vaccine against SARS-CoV-2. Initially, unilateral leptomeningeal enhancement on MRI on the same side of headaches raised suspicion for leptomeningeal involvement of her known cutaneous T-cell lymphoma in remission. After two relatively unremarkable CSF analyses, she underwent a brain biopsy which showed amyloid deposits in vessels instead of lymphomatous infiltration. She was diagnosed with CAA-RI, and the headache and cognitive symptoms responded well to high-dose corticosteroids with a slow taper. Discussion/Conclusion We review the clinical literature of CAA-RI and its potential association with amyloid-related imaging abnormalities (ARIA) after administration of immunotherapy against amyloid.

Social support predicts sleep quality in people with multiple sclerosis during the COVID-19 pandemic.

BACKGROUND: Poor sleep quality is one of the most prominent patient-reported problems in people with multiple sclerosis (PwMS). The COVID-19 pandemic resulted in PwMS having less contact with physicians, therapists, support groups, and family, which led to decreased access to typical supports. The purpose of this study was to assess how social support impacted sleep quality during the COVID-19 pandemic in PwMS within the United States. METHODS: Anonymous surveys were utilized to gather data from February - May 2021 from 209 PwMS during their return appointments (face-to-face and virtual) at the University of Kansas Medical Center (KUMC)'s MS Clinic in the United States. SPSS 27 was used to run four regressions in order to determine if social support predicted sleep quality with and without the inclusion of covariates (age, education, disability, anxiety/depression). RESULTS: The results indicate that overall feelings of being socially supported predict sleep quality. Additionally, various facets of social support predict sleep quality, even when controlling for covariates. Interestingly, while depression and anxiety were significant predictors of sleep quality, those constructs do not attenuate the social support-sleep relationship. CONCLUSION: These findings will provide key information pertaining to the association between social support and sleep in PwMS during COVID-19 where typical supports were limited. Understanding the challenges facing those living with chronic illnesses, specifically PwMS, will help researchers and clinicians alike create interventions to promote social support in the midst of a global pandemic.

The Impact of COVID-19 on the Lives of Individuals With Multiple Sclerosis: 1 Year Into the Pandemic.

Background: The COVID-19 pandemic resulted in implementation of restrictive public health policies requiring people to limit or avoid interaction with others. These policies also had an economic impact. Individuals with multiple sclerosis (MS) already experience higher incidences of depression, anxiety, social isolation, and job loss, and the continuing pandemic may exacerbate these. Methods: Between November 2, 2020, and February 12, 2021, 233 individuals with MS completed the Hospital Anxiety and Depression Scale, the modified Medical Outcomes Study Social Support Survey, the Centers for Disease Control/National Institutes of Health Common Data Element Repository economic impact questions, and study team-designed questions about social and family relationships and adherence to public health policies. Results: Study participants reported high rates of mask wearing, good hand hygiene, and limited interactions with those outside their homes. They felt isolated from family they did not live with, friends, and coworkers. The frequency of conflicts with their spouses/partners increased "a little" among 20% of respondents, but overall relationships with housemates were "unchanged" or "a little better." Ninety-one percent of participants reported experiencing no financial impact. On the Hospital Anxiety and Depression Scale, 16.0% of 218 respondents reported depressive symptoms and 26.8% of 216 reported symptoms of anxiety above the commonly accepted clinically significant cutoff points. Only 3.4% of participants reported contracting SARS-CoV-2. Conclusions: During the first year of the pandemic, this study found no pronounced impact on the emotional, social, or economic stability of the individuals with MS it surveyed. It seems that these study participants adapted to the restrictions created by the pandemic and, by adhering to guidelines, protected themselves from contracting SARS-CoV-2.