MS Research Takes Center Stage at the Consortium of MS Centers’ Annual Meeting
June 15, 2016
More than 2,000 MS health care providers, people living with MS, and other stakeholders gathered at the 30th
Annual Meeting of the Consortium of MS Centers (CMSC) in National Harbor, Maryland, in June 2016 to learn the latest about diagnosing and treating MS, and to hear research updates from more than 200 presentations about progress toward stopping MS, restoring function and ending the disease forever. The meeting also focused on solutions that help people with MS to live their best lives. Many presentations and abstracts from the meeting are being posted here
. Where available, links are provided below to the presentations.
Stopping MS in its Tracks
Many talks focused on efforts to stop MS disease activity, MS progression, and to improve access to MS healthcare. For example, during his Keynote lecture, Dr. Fred Lublin (Mount Sinai School of Medicine, NY, NY) discussed the disabling long-term impacts of MS relapses and the importance of preventing them. Other studies presented showed continued benefits of available therapies and longer-term safety information.
Restoring What’s Been Lost
- Stem cell transplantation results: Several presentations focused on the potential of stem cell therapies for MS, including bone marrow transplantation (HSCT). Dr. Richard Nash (Colorado Blood Institute, Denver) and colleagues reported final results of HALT MS, a small, five-year study of transplantation of the individuals’ own hematopoietic (blood cell-producing) stem cells combined with high-dose immune suppression in 25 people with active, relapsing MS that had not been controlled by disease-modifying medications. They found that after five years, 69% of participants experienced no new disease activity after the procedure and did not need disease-modifying therapies to control their disease. Most side effects were related to blood cell reductions and infections. When the complete data are published, this trial will be an important addition to research needed to determine whether this approach to stem cell transplantation is safe and effective in people with MS. View this presentation
- Dr. Mark Freedman (University of Ottawa) reported results of a long-term HSCT trial involving 24 people with aggressive relapsing-remitting MS whose disease had not been controlled with available therapies. (These results were subsequently published on June 9, 2016.) Three years after the procedure, 70% remained free of disease activity, with no relapses, no new MRI-detected inflammatory brain lesions, and no signs of progression. None of the surviving participants experienced clinical relapses or required MS disease-modifying therapies to control their disease, and 40% experienced reductions in disability. One participant died and another required intensive hospital care for liver complications. All participants developed fevers, which were frequently associated with infections, and other toxicities. Additional research is focusing on figuring out who might benefit from this procedure and how to reduce its risks. Read more about stem cells and MS
- Possible biomarker for MS progression: Dr. Daniel Pelletier (University of Southern California) detailed his team’s research in the CMSC Presidential Lecture. Measuring the nerve signaling chemical glutamate in 500 people with MS annually for four years, they found that higher levels predicted damage to nerve cells and fibers over two years, loss of brain tissue volume and cognitive impairment over four years. Further, larger studies may confirm glutamate as a much-needed biomarker for tracking progression of MS. View this presentation
- Attracting doctors to MS care: Debra Frankel (National MS Society) measured impact among 41 people who had participated in an MS fellowship program as medical students. They had spent four weeks learning about the complexities of MS in comprehensive MS care centers or community-based practices. More than one-third chose neurology or physiatry as their specialties, making it likely that they will encounter people with MS in their practices. All participants reported this as a valuable experience in launching their medical careers. (Abstract #CC13) Find out where this program is offered
- Vegetable protein stops MS in mice: Dr. Jui-Hung Yen (Indiana School of Medicine) and colleagues administered D3T (a protein found in vegetables such as cauliflower, broccoli, and brussel sprouts) to mice with MS-like disease before and after disease onset. If treated before disease onset, disease was delayed and less severe than in untreated mice. If treated after onset, D3T effectively controlled relapses and progression. The protein moderated key players in the immune system attack, making it an attractive candidate for further study. View this presentation
- Time matters in MS: A new MS Brain Health initiative is promoting the message that minimizing delays in the diagnosis and time to treatment can reduce the risks of MS progression. The initiative calls for major policy changes aimed at achieving the best possible outcomes for people with MS and those who care for them. (Abstract #DX41) Read more
- A look to the future: How genes may determine severity of MS Dr. Jamie Imitola (The Ohio State University, Columbus) noted that most MS genes identified in recent years are related to the immune system. But gene studies still haven’t answered what happens to nerve cells in MS, and how damage to them results in progression and disability. The team obtained skin cells from 180 people with various neurologic diseases and programmed them to become stem cells. This enabled the team to characterize 530 different ‘phenotypes’ for nerve cells (sets of characteristics that result from genetics). The resulting database, iphemap.org, can help researchers to understand how the nervous system responds to injury in progressive MS. View this presentation
- High cost of MS therapies: Bari Talente (National MS Society) presented the results of a survey completed online by people in the National MS Society’s database. Of 8778 respondents with MS, 38.9% reported difficulty paying for medication, and 30% reported skipping doses or stropping treatment due to cost; 40.3% were enrolled in pharmaceutical company financial assistance programs. This survey illustrates how medication costs may prevent people with MS from experiencing the benefits of treatment. (Abstract #QL03) Find out how to lower costs
Many researchers focused on ways to restore function to people living with MS, by testing rehabilitation interventions, and addressing symptoms and psychosocial issues.
Ending MS Forever:
- Tai chi for MS symptoms: Dr. Linda Csiza (Texas Women’s University, Dallas) conducted a six-week tai chi program in 25 people with MS. Tai chi classes, which involve meditation using slow controlled movements and deep breathing, were held twice a week for one hour. Tests were administered before and after the program. Of the 15 people who completed the post-tests, balance, endurance, and strength improved and fatigue decreased. (Abstract #RH05) Learn more about Tai Chi
- Depression matters in MS: Depression is a common symptom in MS and can include suicidal thoughts and/or action. Dr. Christine Moutier (American Foundation for Suicide Prevention) noted that prevention works – identifying risk factors, and enhancing protective factors such as connectedness to other people, healthcare providers, or a sense of purpose. View the presentation
In an effort to determine such risk factors, Aliza Ben Zacharia (Mount Sinai Hospital, NY) administered depression scales to 34 people with MS. Of this small sample, about 11% reported having suicidal thoughts, and this was associated with not being married, not being Caucasian, and living alone. Symptoms associated with these thoughts were depression, appetite changes, sadness and loss of pleasure. (Abstract #CG07) Don’t neglect emotional health – read more
- Stopping smoking helps: Dr. Cris Constantinescu (University of Nottingham) reviewed the vast evidence showing how smoking increases the risk for MS development and progression. Perhaps most compelling were the findings that, in people who stopped smoking, the risk of disability decreased 5% in each subsequent year. Dr. Constantinescu urged the research community to take the next step and figure out why people with MS smoke, and develop smoking cessation programs that will succeed. For example, if people are smoking as a coping mechanism, cessation programs could include alternative coping strategies. He cited recent findings on factors that hinder people with arthritis from smoking cessation, which included distraction from pain (read this study). The National Institutes of Health provides resources to help people quit smoking. Visit smokefree.gov or call 800-QUITNOW (800-784-8669). View this presentation
- Addressing pain: Annalisa Sciullo (Yeshiva University, Bronx, NY) and her team found that the extent to which pain interfered with daily life in 61 people with MS was increased with higher levels of fear of movement, catastrophizing (a belief that something is far worse than it actually is), depression and anxiety. These are modifiable factors, so reducing them might reduce pain. (Abstract #CG09) Emma Matthews (Northampton General Hospital, UK) and colleagues treated pain in 60 people with MS using action potential stimulation therapy (in which electrical currents are conducted through the surface of the skin). Within eight weeks, 47 people had significant pain reduction. (Abstract #SX04) Find solutions for pain
- Exercise, cognition and sleep: Society grantee Dr. Catherine Siengsukon (University of Kansas Medical Center, Kansas City) and her team found that both a supervised aerobic exercise program and a home exercise program improved sleep quality significantly in a study of 22 people with MS. The results suggest that exercise might be a way to reduce sleep disturbances that can occur in MS. View this presentation
Dr. Brian Sandroff (Kessler Foundation, West Orange, NJ) and colleagues enrolled 10 women with MS in a three-month, supervised, progressive treadmill-walking exercise program, and compared results with controls placed on a waitlist. There were large effects on cognition as well as cardiorespiratory fitness in this small study, and the effects appeared to be related to one another. View this presentation
Many presentations explored MS risk factors, reporting on associations that yield novel clues to what may trigger the development of the disease.
- Does air pollution increase MS risk? Dr. Elizabeth Triche (Brown University) examined whether there was any association between air pollutants such as carbon dioxide and either blood biomarkers that have been explored in MS, or scales that measure walking ability. Her team showed significant associations with biomarker levels, and with lower scores on walking tests. (Abstract #EG03) Further research is necessary to fine tune these findings. Investigators at Harvard University are currently funded by the Society to explore pollution as an MS risk factor by evaluating data from the Nurses’ Health Studies, which include hundreds of thousands of female nurses followed over the last several decades.
- IUDs and MS risk: Katelyn Kovak (Jacobs MS Center of Treatment and Research, Buffalo, NY) and her team asked 235 women with MS about birth control. They found that age at MS onset was significantly higher in women who used intrauterine devices (IUDs) than those who never did, and age at symptom onset occurred later in women who started using IUDs earlier. Additional research is needed to explore the possible reasons for this finding.(Abstract #EG05)
- The brain’s microbiome: Dr. John Kriesel (University of Utah) and his team have developed methods for identifying microbes – microscopic organisms such as bacteria and viruses – in brain tissue obtained from people with MS via biopsy. They have used these methods to identify several viruses. They compared tissue from 9 people with MS to 14 people with epilepsy, and found significant differences in genetic sequences that instruct bacteria. They are now working to localize specific microbes within the brain tissue. This research is funded by the National MS Society. (Abstract #SC05)