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Preventive Neurology is blog devoted to medical, lifestyle and wellness practices that are designed to avert and avoid neurological disease. For example, screening for hypertension and treating it before it causes diseases such as stroke or dementia, is good preventive neurology. Preventive neurology takes a proactive approach to patient care; prevention is better than having to deal with consequences of neurological disease. 

The activities on this blog are a public engagement tool to support several preventive neurology research initiatives within the Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University London.  

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Are you ready for an EBV vaccine to prevent MS?

"Professor Giovannoni, you tell me that my daughter has a 1 in 40 chance of developing multiple sclerosis and that MS has reached epidemic proportions in parts of the world? Is there anything I can do to reduce her chances of getting MS? Is there anything we can do to stop other people from getting MS?" Although multiple sclerosis (MS) is a complex disease due to the interaction of genetic and environmental factors data on the occurrence of MS at the population level (epidemiology) supports the Epstein Barr Virus (EBV) as being necessary, but not sufficient, for someone to develop MS. In other words, EBV is probably the cause of MS. Of all the putative causative agents that have been proposed to be associated with MS, EBV is the only one where the risk of getting MS if you are EBV negative is close to zero or zero if you limit the analyses to those studies which use a technique called immunofluorescence microscopy as the gold-standard assay to detect anti-EBV antibodies. EBV ...
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Smoking: a major preventable MS risk factor

I have been complaining about my low productivity levels since I have gotten back to work after my accident. However, last night with a single one hour webinar we have managed to set-up a new international collaboration to study and address the social determinants of health (SDoH) and their impact on MS. Our focus is going to be on which SDoH can we modify and hence improve the outcome for people with MS (pwMS)? Smoking is one such modifiable factor and needs to be addressed at a (1) population level with policy and legislation, (2) at a local or community level, (3) with the family and (4) at an individual level target the people with MS (pwMS). We know that pwMS who smoke have a worse outcome than people who don’t smoke. The effect of smoking is equivalent to negating the treatment effect of being on an injectable therapy such as interferon beta. Put simply smokers with MS start using a walking stick (EDSS = 6.0) about 6 years earlier than pwMS who don’t smoke. Getting pwMS to stop s...
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Corpulence and poverty

Since stating my intention to join the  #BackTo21  campaign to get my BMI back to what it was when I was 21 years of age, I have had several emails and direct messages on social media questioning the wisdom of my intention.  Photo by NeONBRAND on Unsplash It is clear that despite BMI being a relatively poor metric of health there is overwhelming evidence that at a population level it predicts poor health outcomes. Importantly there is new data that indicates the target BMI for the prevention of type 2 diabetes and the metabolic syndrome depends on your ethnicity. For people of South Asian origin, there is a call to reset the BMI cutoff to 23.9, which for most people is within the normal range. At the same time, there is a call to classify obesity as an important social determinant of health. Arnaud Chiolero argues below for using BMI as a socioeconomic indicator. Do you agree? Isn’t it quite amazing that in a previous era corpulence was a sign of affluence, whereas in th...
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