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CMSC Meeting Features Solutions to Help People with MS Live Their Best Lives

June 15, 2018

More than 2,300 MS healthcare providers, researchers, people living with MS, and others gathered at the 32nd Annual Meeting of the Consortium of MS Centers (CMSC) in Nashville in May 2018 to share findings and learn the latest about diagnosing and treating MS, and to hear MS research updates. The meeting also focused on solutions that help people with MS to live their best lives. Selected presentations from the meeting are posted here, and a pdf of the abstracts is also available. Below are a few highlights of the meeting, and a blog is posted here. Where available, links are provided to the presentations/abstracts.

“iScreening” for Cognitive Problems: Dr. Stephen Rao (Cleveland Clinic) discussed the MS Performance Test (MSPT), an iPad®-based tool for assessing cognitive function, during the John F. Kurtzke Memorial Lecture. “Many cognitive relapses probably occur but are not picked up, so we miss the opportunity to intervene,” he said, explaining that people with MS do not always perceive their own cognitive problems, so don’t report them. The MSPT is designed to quantify major cognitive symptoms and other outcomes associated with MS. People arrive early for their regular appointments and administer the test themselves, and results are transferred to the doctor immediately. A version is available for free to healthcare providers at www.biogenapp.com. View this presentation

Bile Acid Supplementation for MS? Young investigator Dr. Leah Mische (Johns Hopkins University, Baltimore) and colleagues studied small molecules involved in the metabolism (chemical processes that maintain cell life) of people with MS and people without MS, and found that molecules called bile acids were reduced in people with MS, particularly those with progressive disease. Bile acids have anti-inflammatory and neuroprotective properties. This team is planning a trial of bile acid supplementation in 60 people with progressive MS, with funding from the National MS Society. View the presentation

Raising the Bar: Prof. Alan Thompson (University College London) discussed the past, present and future of rehabilitation research during the Presidential Lecture. “We have a way to go to get the level of evidence exactly where we need it to be,” he said. How do we raise the bar? Dr. Thompson suggested looking to stroke, which has seen tremendous recent growth in rehabilitation research. “Also, is there an overlooked window of opportunity in MS exercise therapy?  Most studies are carried out many years after diagnosis. Is there any possibility that if we did intervene earlier we could have a better effect?” Dr. Thompson cited a call to action by the World Health Organization. “The eyes of the world are on rehabilitation, which has to be good for the future,” he said.

Mindfulness in Motion: Dr. Maryanna Klatt (The Ohio State University, Columbus) developed “Mindfulness in Motion” to stop the impact of chronic stress on bodily function. “Being in a body with MS is a challenge,” she said. “The body can be a reminder of losses, and may be viewed as a source of disappointment.” Mindfulness teaches you to cultivate responses to stress. “It’s about becoming aware of what we consider stressful, our thought patterns.” The program combines mindfulness, yoga, stretches, and music, and involves one hour-long, in-person sessions each week for 8 weeks, along with daily practice sessions using CDs or an MP3 player. In a small study in 22 people with MS, improvements in physical and mental health were observed. Read the study publication

Helping After the Hurricane: Dr. Angel Chinea (San Juan MS Center, PR) and colleagues reported on how a registry of people with MS in Puerto Rico was used to establish the location and needs of people with MS after the island was devastated by Hurricane Maria. The registry had been created previously, helping providers to pinpoint the areas with the most people with MS and establish support groups in those areas. When the hurricane hit, leaving most of the island without power and communication, these resources were used to help deliver aid and form support networks. Read abstract #PF07 on page 68

Access for All: Amy Kunce (VA Medical Center, Baltimore, MD) and colleagues implemented a “telehealth” rehabilitation program in 130 veterans with progressive MS. Participants undergo an in-person assessment, and then six weeks of individualized physical therapy delivered by real-time videoconference. Participants and providers were highly satisfied with the technology. “It really changed my life,” said one participant. “I could do the exercises because I wasn’t already tired from driving to the VA.” The program saved 605 hours in travel time per session, and more than $12,000 in reimbursable travel costs.  Read abstract #RH07 on p. 82. This program is available in East Orange, NJ, Buffalo, NY, Baltimore, MD, Washington DC, St. Louis, MO, Columbia, MO, Charleston, SC, New Orleans, LA, Gainesville, FL, Seattle, WA, Long Beach, CA, Cincinnati, OH, and Honolulu, HI. Veterans who would like to sign up can contact Amy Kunce at Amy.Kunce@va.gov or 410-605-7000 ext. 6271.

Minorities in MS Research: Hollie Schmidt (Accelerated Cure Project for MS) and colleagues surveyed 2,000+ people with MS as part of an effort to increase minority engagement in research. People in all ethnic groups had positive opinions about research and were willing to consider joining a study. However, African-Americans were more concerned about being taken advantage of by investigators, and both African-Americans and Hispanics had a greater preference for studies that might benefit their racial/ethnic community, and for studies that include people of different racial/ethnic groups. Read more on the website of the Patient-Centered Outcomes Research Institute, which is funding the study

Rehab in Severe MS? Yes. Dr. Deborah Backus and colleagues (Shepherd Center, Atlanta) advocated for including exercise and skilled rehabilitation interventions in the care of people with severe MS disability. “People with severe MS are capable of improving in impairment and function,” she said. Disability may partly result from muscle impairment, so interventions targeting muscle are necessary. This team has reported benefits using functional electrical stimulation (cycling using low-level electrical impulses to stimulate leg muscle activation) and antigravity treadmill training (which provides body weight support).

Collaborating to End MS Progression: Investigators reported on Collaborative Network Awards supported by the International MS Progressive Alliance:
  • Dr. Sridar Narayanan (McGill University, Montreal, CA) and colleagues are developing imaging markers that signal progression, and adapting them for use in trials. The team, led by Dr. Douglas Arnold, has collected data from more than 7000 participants and 25,000 MRI scans so far. They are using a type of artificial intelligence that involves computers automatically learning patterns from data. View this presentation
  • Dr. Linda Ottoboni (San Raffaele Scientific Institute, Milan, Italy) and colleagues are seeking to identify molecules that may be neuroprotective or promote myelin repair. Led by Dr. Gianvito Martino, this team is identifying treatments that can be repurposed for MS using high-tech screens, testing them in laboratory dishes, and then in MS-like models. View this presentation
  • Dr. Francisco Quintana (Brigham and Women’s Hospital) and colleagues are seeking to identify drug candidates that may be effective therapies for progressive MS. They are targeting the “innate” immune system, which normally protects the body from infections. Several molecular targets have been identified, as well as pathways for which there are existing drug or probiotic treatments. The team is following up on leads and continuing their screening efforts. View this presentation

About Multiple Sclerosis

Multiple sclerosis is an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body. Symptoms range from numbness and tingling to blindness and paralysis. The progress, severity and specific symptoms of MS in any one person cannot yet be predicted, but advances in research and treatment are leading to better understanding and moving us closer to a world free of MS. Most people with MS are diagnosed between the ages of 20 and 50, with at least two to three times more women than men being diagnosed with the disease. MS affects more than 2.3 million people worldwide.

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