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MS Blog & Podcast

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.

Apr 12 2022 MS Living Well Podcast: Aging and Multiple Sclerosis

Image: Maria Lupan on Unsplash

Our immune systems become less robust as we age. With an autoimmune disease such as multiple sclerosis, a weakened immune system can lead to less relapses and active MRI lesions.  However, many people living with multiple sclerosis develop progressive disease with worsening physical and cognitive disability as they age. Strategies to live better with MS as one grows older are shared.

The vast majority of treatments for multiple sclerosis have been studied in people 55 years of age or younger. However, 46% of people living with MS are older than age 55.  New studies are answering important questions about MS treatment in older patients. At what age, can treatment safely be stopped without risk of relapse or worsening disability? Safety concerns such as serious infections, cancer risk and immunization responsiveness in older MS patients on immunosuppressive treatments are addressed.

Season 4 MS Living Well podcast is sponsored by Octave.

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

Bianca Weinstock-Guttman MD

Bianca Weinstock-Guttman MD is a Professor of Neurology at the Jacobs School of Medicine & Biomedical Sciences in Buffalo, New York. She is the Director of the Jacobs MS Center for Treatment and Research since 2002. Dr. Weinstock-Guttman competed a fellowship in neuroimmunology at the Cleveland Clinic. She serves as executive director of the New York State Multiple Sclerosis Consortium.

John Corboy MD

John Corboy MD is a Professor of Neurology at the University of Colorado Denver, School of Medicine and Co-Director of the Rocky Mountain MS Center.  Dr. Corboy did his undergraduate, medical school, and Neurology training at the University of Pennsylvania, and completed his postdoctoral fellowship at John Hopkins. In 1997, he founded the University of Colorado Multiple Sclerosis Center, and has built it into a multidisciplinary group offering state-of-the-art care and research to MS patients.

 

Mar 29 2022 MS Living Well Podcast: Diet & Multiple Sclerosis

Photo: Louis Hansel on Unsplash

Trying to figure out the ideal diet for multiple sclerosis? Two of the leading experts on diet and multiple sclerosis share our current understanding based on the latest research. Diets reviewed include intermittent fasting, Swank diet, Wahls protocol and Mediterranean diet. The role of the gut organisms, called the microbiome, on immune health explained.

In-depth information highlighted how certain foods affect people living with multiple sclerosis. Specifically dairy, gluten, polyunsaturated fats, fruits, vegetables, salt, vitamins and supplements are covered.  Dr. Ellen Mowery and Dr. Ilana Katz Sand also discuss how they counsel their own MS patients on diet.

Season 4 MS Living Well podcast is sponsored by Octave.

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

Ellen Mowry MD

Ellen Mowry MD is a Professor of Neurology and Epidemiology at Johns Hopkins University. Dr. Mowry also co-directs the Johns Hopkins MS Precision Medicine Center of Excellence. She completed her undergraduate degree Georgetown University and medical school at the University of Rochester. After finishing her neurology residency at the University of Pennsylvania, she completed a fellowship in multiple sclerosis and master’s degree in clinical research at the University of California San Francisco. Her research focuses on environmental factors that influence the risk and prognosis of multiple sclerosis.

Ilana Katz Sand MD

Ilana Katz Sand MD is an Associate Professor of Neurology at the Icahn School of Medicine at Mount Sinai and on staff at the Corinne Goldsmith Dickinson Center for MS in New York City. She attended college at University of Pennsylvania and medical school at Columbia University College of Physicians and Surgeons. She completed her neurology residency at Columbia University followed by a fellowship at Mount Sinai and joined the faculty at Mount Sinai following completion of her fellowship in 2013. One of main areas of her research is the role of diet in MS.

Jan 25 2022 MS Living Well Podcast: Multiple Sclerosis: Cause & Cure

EBV or Epstein-Barr virus causes MS based on new research. Image: iStock

The Epstein-Barr virus (EBV) causes multiple sclerosis based on a new monumental study in young adults serving on active duty in the US military.  The risk of developing MS increased 32-fold after infection with the Epstein-Barr virus. EBV causes infectious mononucleosis, spreads through saliva and infects B immune cells.

Alberto Ascherio MD DrPH from Harvard T.H. Chan School of Public Health shares on the podcast his group’s recent findings published in Science.  Epstein-Barr virus treatments in clinical trials reviewed including vaccination studies with the goals of stopping disease progression and preventing MS from ever occurring. The impact of vitamin D, smoking and childhood obesity on the risk of developing multiple sclerosis is reviewed.

Howard Weiner MD, Harvard Professor of Neurology, Director and Founder of the Partners Multiple Sclerosis Center, details the genetic risk factors for developing multiple sclerosis such as human leukocyte antigen (HLA) and risks of passing the disease onto children.  The role of gut organisms, known as the microbiome, in both potentially causing multiple sclerosis and protecting people with the disease is explored. Strategies for a multiple sclerosis cure are highlighted.

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

Howard Weiner MD

Howard L. Weiner MD is the Robert L. Kroc Professor of Neurology at the Harvard Medical School, where is has been on faculty since 1976. He is the Director and Founder of the Partners Multiple Sclerosis Center as well as the Co-Director of the Center for Neurologic Diseases at the Brigham & Women’s Hospital in Boston. In 2007, Dr. Weiner received the prestigious John Dystel prize for Multiple Sclerosis Research awarded by the American Academy of Neurology. He is also a film writer, director and author. Dr. Weiner is the author of “Curing MS.” His latest book is “The Brain Under Siege: Solving the Mystery of Brain Disease, and How Scientists are Following the Clues to a Cure.”

Alberto Ascherio MD DrPH

Alberto Ascherio MD DrPH is Professor of Epidemiology & Nutrition at the Harvard Chan School of Public Health. Dr. Ascherio obtained his medical degree at the University of Milan in 1978. He practiced medicine and public health in Latin America and Africa for several years and then moved to Boston, where he received a doctoral degree in epidemiology from Harvard in 1992 and then joined the faculty.  His research group focuses on identifying causes, risk factors and biomarkers of susceptibility and early diagnosis of multiple sclerosis including key research on Epstein-Barr virus and vitamin D.

Season 4 MS Living Well podcast is sponsored by Octave.