Impact of Ketone Bodies and Epigallocatechin Gallate in Multiple Sclerosis

Quantitative electroencephalogram (QEEG)

A QEEG brain map (or 'Q' for short) enables us to see your unique pattern of mental strengths and weaknesses - areas of the brain where there is too little or too much activity, and areas that are not coordinating their activity the best they could.

Time frame: 0-4 months

Betahydroxybutyrate

Beta-hydroxybutyrate (BHB) inhibits the NLRP3 gene, which is part of a complex set of proteins called the inflammasome. The inflammasome drives the inflammatory response in several diseases, among which are some autoimmune diseases.

Time frame: 0-4 months

C-reactive protein

C-reactive protein (CRP) is produced by the liver. The level of CRP rises when there is inflammation throughout the body. This is one of a group of proteins called "acute phase reactants" that increase in response to inflammation.

Time frame: 0-4 months

Haptoglobin

Haptoglobin is an acute phase protein whose expression is a response proportional to inflammation

Time frame: 0-4 months

Field oxide (FOX)

The method is based on the principle of the rapid peroxide-mediated oxidation of Fe2+ to Fe3+ under acidic conditions.

Time frame: 0-4 months

Total antioxidants (TEAC)

TEAC is a spectrophotometric technique that is based on inhibition from the antioxidants of the absorbance of the radical cation of 2,2'-Azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt (ABTS) (2,2'-azinobis (3-ethylbenzothiazoline-6-sulfonate), a stable blue-green chromophore that has a characteristic long wavelength absorption spectrum

Time frame: 0-4 months

Copper reduction capacity (CUPRAC)

CUPRAC method based on the reduction of Cu (II) in hydroetanolic medium (pH 7.0) in the presence of neocuproin (2,9-dimethyl-1,10-phenanthroline), by polyphenols resulting in complexes of Cu.

Time frame: 0-4 months

Iron reduction capacity (FRAP)

The FRAP assay, is presented as a novel method for assessing ''antioxidant power.'' Ferric to ferrous ion reduction at low pH causes a colored ferrous-tripyridyltriazine complex to form.

Time frame: 0-4 months

Paraoxonase 1 (PON1)

The enzyme Paraoxonase 1 (PON-1), is synthesized in the liver and is attached to the apolipoprotein A1 of high density lipoprotein (HDL). PON1 is able to hydrolyze organophosphates compounds (e.g. paraoxon, diazoxon, soman, sarin), has arylesterase and lactonase function by hydrolyzing lactones, homocysteine thiolactone specifically to regenerate homocysteine.

Time frame: 0-4 months

Anxiety

The State-Trait Anxiety Inventory (STAI). This is a self-report measure of immediate and general anxiety. A patient is shown or read aloud a statement (e.g. 'I feel jittery') and is required to indicate to what degree, from a choice of four frequencies, the statement relates to them. Range score for each subtest is 20-80, the higher score indicating greater anxiety. A cut point of 39-40 has been suggested to detect clinically significant symptoms for the State Anxiety.

Time frame: 0-4 months

Depression

Beck Depression Inventory (BDI). This is a self-report measure of depression. A patient is shown or read aloud groups of four statements, which range from a normal thought to a profoundly depressed thought. The patient must indicate which of the four is closest to how they have been feeling over the past week. The range score is 0-63, the higher score indicating greater depression.

Time frame: 0-4 months

Satiety

Perceptions of hunger, desire to eat and satiation were performed by VAS, which provides an accurate way to predict appetite in young adults and has good reproducibility. VAS, 100mm in lenght with words anchored at each end, expressing the most positive and the most negative rating, were used to assess hunger, satiety, fullness, prospective food consumptions best represented their sensation at the time. The volunteers were instructed to make a point at the point where best represented their sensation at the time.

Time frame: 0-4 months

Sociodemographic

The demographic characteristics (age, gender, etc.) and clinical characteristics (year of diagnosis, type of multiple sclerosis, etc.) of the sample were measured through an ad hoc sociodemographic questionnaire.

Time frame: 0 months

Berg

This scale rates performance from 0 (cannot perform) to 4 (normal performance) on 14 items with a maximum total score of 56.18,19 The validity and reliability of the scale have been assessed on populations of subjects with multiple sclerosis.

Time frame: 0-4 months

Exercise tolerance

The Two-minute walk test (2MWT) is a short version of an exercise tolerance test and reports the distance in meters during a 2-minute walk. The objective of the test is to walk as far as possible for 2 minutes. Participants, remembering the objective, walked at a comfortable speed between 2 cones that were 20m apart. If they had to turn, they moved the unaffected side. They were permitted to slow down, stop, and rest as necessary during the 2-minute walk. The time was started when participants started walking and proceeded until 2 minutes elapsed, even if they slowed down or stopped walking. The instructions were, "Go. Keep walking until I say 'stop' or until you are too tired, and stop when I say 'stop.'"

Time frame: 0-4 months

Gait speed

The 10-meter walk test is a simple, effective and widely used tool to evaluate gait speed. The 6MWT evaluates endurance by measuring the maximum distance an individual can walk within 6 min, and determines the walking capacity.

Time frame: 0-4 months

Physical function and symptoms

Disabilities of the arm, shoulder and hand (DASH) 30 items, self-report rating scale will be used to measure physical functions and symptoms' in people with disorders of the upper limb. Items are scored from 1 (no difficulty) to 5 (unable). A total 'disability/symptom' score is generated by summing items, and averaging to produce a mean item score between 1 and 5. This value is then transformed to a score out of 100 by subtracting one and multiplying by 25. A higher score indicates greater disability.

Time frame: 0-4 months

Neurological impairment

Kurtzke's Expanded Disability Status Scale (EDSS) is the most widely used measure which attempts to capture the full extent of MS symptoms in a standardised way. It was selected for this study because of its universal currency. Both the EDSS and Functional Systems were recorded. The EDSS provides a total score on scale that ramges from 0 to 10. The higher degrees means more disability.

Time frame: 0-4 months

Manual dexterity

It was measured with the Nine Hole Peg Test (NHPT). The time needed to place and remove 9 pegs was recorded and averaged over 2 trials. Manual dexterity speed was calculated as pegs per second and used in the analyses. Participants who were not able to place any peg within a time limit of 300 seconds received a score of 0 pegs per second.

Time frame: 0-4 months

Hand Grip Strength

The instrument used was a Jamar handgrip dynamometer. The dynamometer has a dial meter. Its handle was positioned in the second notch. In that position the grip width was approximately 4.0 cm

Time frame: 0-4 months

Muscle power

The muscle scale qualifies muscle power on a scale of 0 to 5 in relation to the maximum expected for that muscle.

Time frame: 0-4 months

Muscle Strength Assessment Dynamometer (NEDDFM/IBV )

This allows the determination of the degree of muscular weakness of the large muscular groups of lower and upper limb in the different planes of movement. The system assists the evaluator, providing, in real time, the force exerted by a certain muscle group, the maximum effort reached during the exercise and the corresponding deficiency according to the scales of RD 1971/1999 or the AMA disability assessment tables. The results of the assessment can be displayed on the screen and printed on a report card.

Time frame: 0-4 months

Body diameters

Distance taken in projection, between two anatomical points and measured in centimeters (cm), through a pachymeter.

Time frame: 0-4 months

Body perimeters

They are indicators of body fat and protein reserves, so they are useful to know the nutritional status. Perimeters from the thorax, waist, arm, forearm and thigh, will be measure in centimeters (cm), through a tape measure.

Time frame: 0-4 months

Skinfold calipe

This method is based on the measurement of the thickness of the subcutaneous adipose tissue in precisely defined and protocolized places, measured with a pleximeter and taking into account the guidelines of the ISAK (The International Society for Advancement of Kinanthropometry).

Time frame: 0-4 months

Height

It is expressed in centimeters (cm), measuring the distance between the vertex and the plane of support of the individual by means of a stadiometer and placing the head on the Frankfort plane

Time frame: 0-4 months

Weight

Sum of fat mass and lean mass, expressed in kilograms (kg) and measured by clinical scale.

Time frame: 0-4 months