Department of Neurology, Johns Hopkins School of Medicine, 600N Wolfe St, Pathology 627, Baltimore MD, 21287, USA.
Corrine Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center, New York City, NY, USA.
Mult Scler Relat Disord. 2020 Jan;37:101478. doi: 10.1016/j.msard.2019.101478. Epub 2019 Oct 29.
Disease course in people with multiple sclerosis (MS) is heterogeneous. The impact of dietary and nutritional factors on MS prognosis is of interest to both patients and clinicians; differences in diet are hypothesized to contribute to disease evolution over time. However, studying diet, especially in people with MS, introduces methodologic complexity that should be recognized. In this review, we focus on methodological aspects relevant to the conduct of dietary interventions in people with MS, given our experience in leading such studies and the challenges we encountered in the realization of this work. We summarize key aspects of study design and important considerations, regardless of the specifics of the actual study (e.g. the particular diet of interest, target MS population, etc.). We discuss strategies for the design of the intervention as well as the selection of appropriate study endpoints. Finally, we provide an overview of strategies to improve the rigor of conducting dietary studies in people with MS.
多发性硬化症（MS）患者的疾病进程存在异质性。饮食和营养因素对 MS 预后的影响引起了患者和临床医生的关注；饮食的差异据推测会导致疾病随时间的演变。然而，研究饮食，特别是在 MS 患者中，引入了方法学的复杂性，这一点应该得到认识。在这篇综述中，我们重点关注与在 MS 患者中进行饮食干预相关的方法学方面，鉴于我们在领导此类研究方面的经验以及在实现这项工作时遇到的挑战。我们总结了研究设计的关键方面和重要考虑因素，而不考虑实际研究的具体情况（例如，特定的饮食、目标 MS 人群等）。我们讨论了干预设计的策略以及选择适当的研究终点的策略。最后，我们概述了在 MS 患者中进行饮食研究的严谨性的提高策略。
