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Jul 11 2023 MS Living Well Podcast. Inside MS: Navigating Inflammation

Dive into a deeper understanding of the role of inflammation in causing injury to the brain and spinal cord in multiple sclerosis. It’s a journey marked by ups and downs, where the adaptive immune system composed of lymphocytes (T and B cells) attack myelin and the innate immune system clears damaged myelin. An immune cell called microglia can create smoldering inflammation in MS that poses a threat of progressive disability.

Explore the arsenal of MS treatment strategies developed over the past 3 decades to either alter or suppress the immune system to reduce inflammation. Triumphs and limitations of our current MS therapies shared. Antioxidant research, diet and new therapeutics tackling smoldering inflammation bring newfound hope.

Episode is sponsored by EMD Serono.

Prof. Klaus Schmierer

Klaus Schmierer MB BS, PhD, FRCP is a Professor of Neurology at the Blizard Institute, Queen Mary University of London, and Consultant Neurologist at The Royal London Hospital, Barts Health NHS Trust, where he is the Research Lead for Neurology. He completed his neurology training at the Charité Hospital at Humboldt University in Berlin. His MS research interests include epidemiology and cause(s) of MS, quantitative MRI imaging and clinical trials.

Michael Kornberg MD PhD

Michael Kornberg MD, PhD is an Assistant Professor of Neurology at John Hopkins. He completed college at Yale University. He received M.D. and Ph.D. degrees from the Johns Hopkins School of Medicine and stayed at Johns Hopkins for neurology residency and a clinical and research fellowship in neuroimmunology. Dr. Kornberg conducts research aimed at better understanding the processes that drive MS progressive disability such a neurodegeneration and remyelination failure.

Jun 20 2023 MS Living Well Podcast: Multiple Sclerosis in Childhood

 

Yes, children can get multiple sclerosis. Children ages 12 and up are more typically affected and rarely before age 8.  Awareness is essential for prompt diagnosis and treatment of pediatric-onset MS (POMS).  Accurate diagnosis of multiple sclerosis in children requires screening for other conditions like MOG antibody-associated disease (MOGAD). Risk factors associated with higher rates of developing MS in kids include Epstein-Barr virus infection, genetic susceptibility, pesticide exposure, smoking (and secondhand smoke), low vitamin D, obesity and diet high in saturated fats.

Multiple sclerosis in kids can be very active with frequent relapses and concerning MRI activity. Rapid use of highly effective treatment is important to preserve brain health including cognition. Completed and ongoing global pediatric trials are redefining care. Oral fingolimod, for example, reduced relapses by 82% compared to interferon beta-1a injections weekly. Thanks to treatment advancements, teens living with MS have a brighter future ahead of them.

This podcast episode is sponsored by Octave.

Barry Singer, Director of The MS Center for Innovations in Care, interviews:

Brenda Banwell MD

Brenda Banwell MD is Chief of the Division of Neurology and Co-Director of the Neuroscience Center at the Children’s Hospital of Philadelphia (CHOP). She is a Professor of Neurology and Pediatrics at the Perelman School of Medicine at the University of Pennsylvania. She completed her pediatric residency at Children’s Hospital of Western Ontario, a pediatric neurology residency at the University of Toronto-The Hospital for Sick Children and a fellowship at Mayo Clinic.  Dr. Banwell advocates for pediatric multiple sclerosis patients as the Chair of the International Pediatric Multiple Sclerosis Study Group and as Director of the International Medical and Scientific Advisory Board of the Multiple Sclerosis International Federation.

Emmanuelle Waubant MD PhD

Emmanuelle Waubant MD, PhD is a Professor of Neurology at the University of California San Francisco and serves as director of the UCSF Regional Pediatric Multiple Sclerosis Center. She studies environmental and genetic risk factors, including in children with the disease. A native of France, Dr. Waubant completed a residency in neurology at Toulouse University Hospital and a fellowship training in neuroimmunology at UCSF. She chairs the clinical trial task force and serves on the steering committee of the International Pediatric Multiple Sclerosis Study Group.

May 30 2023 MS Living Well Podcast: Being Diagnosed with Multiple Sclerosis

Julian Gamboa shares his first symptoms of multiple sclerosis including spinning sensation and double vision. He had substantial obstacles and setbacks in being diagnosed including a prolonged hospitalization. After being in a very low place, Julian rallied with the support of others including his family. He conveys how he eventually obtained superb MS care and utilizing his social media guru skills to help others being diagnosed with MS.

Dr. Jakai Nolan

Dr. Jakai Nolan opens up about her own unique insights on being diagnosed with multiple sclerosis since she is both a neurologist specializing in multiple sclerosis and a person living with MS. As she shares her own personal story, she reviews key symptoms suggestive of MS and the importance of advocating for prompt evaluation to prevent a delay in diagnosis and treatment. Dr. Nolan covers treatment selection, mental health concerns and lifestyle modifications for someone recently diagnosed.

This podcast episode is sponsored by Octave.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Julian Gamboa

Julian Gamboa is the Social Media Director for Maximum Effort, supporting brands affiliated with Ryan Reynolds including Mint Mobile, Aviation Gin and Wrexham AFC. He received his BA in marketing from the University of California, Berkeley. Previous work experience includes leading Telemundo LA’s first organic social strategy in live streaming and celebrity advertising and senior marketing and social media manager at Adweek. In 2017, LinkedIn recognized Mr. Gamboa as a Marketing and Social Media Top Voice. In late 2021, Mr. Gamboa was diagnosed with multiple sclerosis and serves on the Board of Directors of the Multiple Sclerosis Association of America.

Dr. Jakai Nolan

Dr. Jakai Nolan is a neurologist specializing in multiple sclerosis in Villa Rica, Georgia and Endowed Neurology Chair for Tanner Medical Center. She received her undergraduate degree in Neuroscience from Vanderbilt University, a Master’s degree in Public Health at Emory University and her medical degree from Philadelphia College of Osteopathic Medicine, Georgia Campus. Dr. Nolan completed her residency training in neurology at Kettering Medical Center in Dayton, OH and a clinical fellowship in neuroimmunology/multiple sclerosis and spasticity management at Riverside Medical Center in Columbus, OH.

May 9 2023 MS Living Well Podcast: Earliest Stages of Multiple Sclerosis

 

Years before the first typical neurological symptoms of multiple sclerosis such as numbness or visual loss, individuals can have other symptoms that are often overlooked. This period of time is called the MS prodrome. During the prodrome phase, there is an increase in symptoms including skin, gastrointestinal and psychiatric issues. Research may lead to earlier detection of MS.

Sometimes brain spots or “lesions” typical of multiple sclerosis can be surprisingly found in people who get an MRI scan of the brain for unrelated reasons such as headaches or head trauma. If the person never had MS symptoms, it’s called radiologically isolated syndrome (RIS). RIS risk factors that really increase the risk of a MS relapse include spinal cord lesions, oligoclonal bands in spinal fluid and new MRI lesions over time. Clinical trials for RIS treatment reviewed including recent positive results.

This podcast episode is sponsored by Octave.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Helen Tremlett PhD

Helen Tremlett PhD is a Professor in the Division of Neurology at the University of British Columbia and the Canada Research Chair in Neuroepidemiology and Multiple Sclerosis. She trained in pharmacoepidemiology and multiple sclerosis with a PhD from Cardiff University, UK. Her ongoing research studies include the MS prodrome, safety and effectiveness of the disease-modifying drugs for MS; pharmacogenomics; risk of MS in special populations; impact of comorbidities on MS outcomes; and the gut microbiome and MS.

Erin Longbrake MD PhD

Erin Longbrake MD PhD is an Associate Professor of Neurology at Yale School of Medicine. She is Director of Neuroimmunology Clinical Research and Director of the fellowship program. She received her MD & PhD degrees at The Ohio State University. Dr. Longbrake completed her neurology residency and was a Sylvia Lawry fellow of the National MS Society from 2013-2016 at Washington University in St. Louis.

Apr 18 2023 MS Living Well Podcast: Is My MS Controlled?

Knowing which MS changes are significant enough to warrant speaking up can be hard. Relapses can occur every 1-2 years without treatment, but much less frequently on disease-modifying treatment. Distinguishing between an actual relapse, a pseudorelapse or just brief worsening of symptoms (Uhthoff’s phenomenon) explained. Options for relapses such as steroids, plasmapheresis and ACTH are reviewed. Importance of MRI monitoring addressed since most new MS lesions pop up on MRI scans without actual symptoms.

Slow progression of disability can be challenging to detect. Physical changes can include slower walking, worsening balance and more hand coordination problems. Cognitive worsening may be noticeable due to short-term memory loss, word-finding issues and multitasking challenges. Tools to improve monitoring for disease progression highlighted such as in-office testing, remote electronic monitoring and biomarker blood testing. Why multiple sclerosis disability can worsen without MRI change explained. Ways to better advocate for prompt care of worsening MS shared.

This podcast episode is sponsored by Octave.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Jacqueline Nicholas, MD

Jacqueline Nicholas MD is System Chief of Neuroimmunology & Multiple Sclerosis, Director of MS Research and Neuroimmunology Fellowship Director at the OhioHealth Multiple Sclerosis Center.  She completed her neurology residency at the University of Pittsburgh Medical Center, serving as chief neurology resident. Dr. Nicholas completed a fellowship in clinical neuroimmunology, multiple sclerosis and spasticity and a Master of Public Health at The Ohio State.

James Bowen, MD

James Bowen MD is Medical Director of the Multiple Sclerosis Center at Swedish Neuroscience Institute in Seattle as well as a Clinical Associate Professor of Neurology at the University of Washington in Seattle. He received his medical degree from Johns Hopkins University in Baltimore and completed his neurology residency at the University of Washington. Dr. Bowen has served many roles within the National MS Society, including serving on the National Clinical Advisory Board.

Jul 31 2022 Insights on Multiple Sclerosis in India

Multiple sclerosis lecturers including Dr. Barry Singer being honored at the Madras Medical College in Chennai, India.

The true prevalence of multiple sclerosis in India is unknown, but a new national registry should hopefully provide insights. During my visit to AIIMS (All India Institute of Medical Sciences) in Delhi, Professor Padma Srivastava shared with me that over 1000 MS patients have been entered into the registry so far through a network of neurologists around India. Multiple sclerosis is being diagnosed more readily due increasing access to well-trained neurologists and widespread availability of relatively low-cost MRI imaging.

It was my honor to be invited to lecture at government hospitals to share the United States changes in MS care including early use of high efficacy treatment for appropriate patients. Special thanks to Professor Neera Chaudhary at Safdarjung Hospital in Delhi and Professor R. Lakshmi Narasimhan at Madras Medical College in Chennai and their department faculty for sharing their insights in MS care of Indian patients. In addition, I learned about the high rates of neuromyelitis optica in India similar to many other Asian countries.

Awareness of multiple sclerosis in India is critical for earlier diagnosis and treatment. Monoclonal antibody and generic oral disease-modifying therapies are available, but health inequalities still exist. In this era of numerous treatment options, the prognosis for someone living with MS is much more favorable than prior generations. In India, the stigma of being diagnosed with MS often results in young individuals not being able to marry and have families. Strong advocacy efforts will hopefully lead to change and improved quality of life for those living with MS in India.

Jun 7 2022 MS Living Well Podcast: Personalized Medicine for MS

With over 20 options, what is the best multiple sclerosis treatment for me? Selecting an appropriate disease-modifying therapy (DMT) needs to consider your risk of worsening disability over time. Your age, sex and race can affect your prognosis and can influence the power of treatment chosen. Details about your early relapses and MRI activity are very important for treatment decisions.

Treatment selection should also consider responsiveness to vaccines, family planning and other medical problems (another autoimmune disease or cancer). For each individual living with multiple sclerosis, balancing power of treatment against serious risks of treatment needs to be considered.  The future of personalizing care to better pick the right medication shared.

Season 4 MS Living Well podcast is sponsored by Octave.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Celia Oreja-Guevara MD PhD

Celia Oreja-Guevara MD PhD is the Vice Chair of Neurology and Head of the Multiple Sclerosis Center at the University Hospital, San Carlos, Madrid, Spain and an Associate Professor of Neurology at the Complutense University of Madrid, Spain. Dr Oreja-Guevara received her MD from the Complutense University of Madrid and PhD in neuroimmunology at the Max Planck Institute of Neurobiology, Munich, Germany. She completed her residency at the Ruhr-University Bochum, Germany and went on to complete a postdoctoral fellowship in neuroimaging at the San Raffaele Hospital, Milan, Italy.

John Foley MD

John Foley MD is Director of the Rocky Mountain MS Clinic in Salt Lake City, Utah which he founded in 2006. Dr. Foley earned his medical degree from the Medical College of Wisconsin and went on to complete his residency in Neurology at the University of Utah. He formerly served as Chief over the Division of Neurology at LDS Hospital in Salt Lake City.

May 24 2022 MS Living Well Podcast: Digital Health & MS

Image: iStock

Digital technology has transformed our lives. For people living with multiple sclerosis, electronic health opens a new world. Biosensors in our smartphones and wearable devices can monitor physical activity levels and sleep and may detect MS disease changes faster than that next neurologist appointment. New apps can help people with MS manage and track their disease including gaming to assess cognition.

Digital health is becoming an indispensable part of in-office and virtual patient appointments. Privacy concerns with electronic healthcare addressed. Treatment decisions facing both doctors and patients are getting increasingly complex. New artificial intelligence technology may soon help personalize treatment and predict treatment response using a concept of a digital twin.

Season 4 MS Living Well podcast is sponsored by Octave.

Barry Singer MD, Director of The MS Center for Innovations in Care interviews:

Jennifer Graves MD PhD is an Associate Professor at UC San Diego School of Medicine and serves as Director of the UC San Diego Neuroimmunology Research Program. Dr. Graves completed a fellowship in neuro-ophthalmology and residency in neurology at the University of Pennsylvania Perelman School of Medicine. She earned her medical degree and PhD in molecular biophysics from University of Texas Southwestern Medical School. She also holds a master’s degree in epidemiology and biostatistics from UC San Francisco.

Dr. Tjalf Ziemssen

Tjalf Ziemssen MD PhD is founder and director of the MS Center in Dresden, Germany where he did his neurology training. Professor Ziemssen is also Director of the Center of Clinical Neuroscience and the neuroimmunological lab at the Carl Gustav Carus University Hospital in Dresden. He completed his medical training and doctoral thesis at the University of Bochum. He also was a research fellow at the Max Planck Institute of Neurobiology. As a leader in the field of multiple sclerosis, he has published over 350 scientific articles.

May 10 2022 MS Living Well Podcast: Vision & Multiple Sclerosis

 

 

Multiple sclerosis frequently causes visual impairment. 70% of people living with the disease can develop optic neuritis at some point and often the first sign of MS.  The symptoms, medical evaluation, treatment and prognosis of optic neuritis are conveyed.  Besides multiple sclerosis, other causes are discussed including MOG antibody-associated disease (MOGAD) and neuromyelitis (NMO).

Double vision and shaky (or jumpy) vision are other concerning visual symptoms for people with MS. The reason for these eye movement abnormalities and detailed treatment options are covered. Experts share the latest advancements in vision research for those living with multiple sclerosis.

Season 4 MS Living Well podcast is sponsored by Octave.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Dr. Anneke Van Der Walt

Dr. Anneke van der Walt is an Associate Professor of Neurology at Monash University in Melbourne, Australia. She is the head of the MS and Neuro-ophthalmology Research Group. She completed her undergraduate work in South Africa and completed her neurology training and PhD at the University of Melbourne. She is also the Chief Operating Officer of MSBase Foundation.

Dr. M. Tariq Bhatti

Dr. Tariq Bhatti is a neuro-ophthalmologist currently at Kaiser Permanente in Northern California. He completed his neuro-ophthalmology fellowship at Emory.  Dr. Bhatti was most recently a Professor of Ophthalmology and Neurology at Mayo Clinic and previously Chief of Neuro-ophthalmology at Duke University.  Dr. Bhatti has authored or co-authored over 180 scientific articles.

 

Apr 26 2022 MS Living Well Podcast: Multiple Sclerosis Biomarkers including Blood Tests

Photo: Rawpixel

Rapid recent advancements have led to blood tests (biomarkers) to track multiple sclerosis disease activity. A biomarker is a something that can be measured to check normal functioning or the impact of a disease. Blood biomarkers are common in medicine to measure response to therapy such as measuring hemoglobin A1c levels for diabetic control and cholesterol levels for high cholesterol treatment.

Injury to nerve cells (neurons) and other cells in the brain and spinal cord can be measured in the blood by checking levels of proteins such as neurofilament light chains (NfL) and glial fibrillary acid protein (GFAP). One panel of these blood markers helps identify people with multiple sclerosis with current active MRI scans. The future of MS biomarkers involves blood tests to diagnose multiple sclerosis, select the best treatment for an individual and measure treatment response.

Season 4 MS Living Well podcast is sponsored by Octave.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Tanuja Chitnis MD

Tanuja Chitnis MD is a Professor of Neurology at Harvard Medical School. Dr. Chitnis is Director of both MGB Pediatric Multiple Sclerosis Center and Translational Neuroimmunology Research Center at Brigham and Women’s Hospital. She is also Co-Director of the Brigham Multiple Sclerosis Center at Brigham and Women’s Hospital.  She oversees a team of analysts and postdoctoral fellows working to identify biomarkers for precision treatment in MS patients.  She has authored over 250 publications and reviews related to MS and demyelinating disorders.